Individual
DEBRA RICHARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14121 DEVAN LEE DR W, JACKSONVILLE, FL 32226
(904) 379-0354
(904) 551-5321
Mailing address
14121 DEVAN LEE DR W, JACKSONVILLE, FL 32226-5825
(904) 379-0354
(904) 551-5321
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906683
FL
311ZA0620X
Adult Care Home Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010788600
—
FL
Enumeration date
08/28/2016
Last updated
01/27/2019
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