Organization
THERAPY SOURCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN DIANNE DRISCOLL (PRESIDENT/CEO)
(904) 396-1462
Entity
Organization
Contact information
Practice address
3311 BEACH BLVD, JACKSONVILLE, FL 32207-3704
(904) 396-1462
(904) 396-1199
Mailing address
3311 BEACH BLVD, JACKSONVILLE, FL 32207-3704
(904) 396-1462
(904) 396-1199
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891337400
—
FL
Enumeration date
01/30/2007
Last updated
07/26/2013
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