Organization
FROM THE HEART MEDWAIVER PROVIDER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARLOTTE JEAN CARUSO (PRESIDENT)
(904) 764-3127
Entity
Organization
Contact information
Practice address
3001 PERCY RD, JACKSONVILLE, FL 32218-2325
(904) 764-3127
(904) 764-2659
Mailing address
3001 PERCY RD, JACKSONVILLE, FL 32218-2325
(904) 764-3127
(904) 764-2659
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
FL
Other
Enumeration date
08/02/2006
Last updated
06/05/2008
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