Individual
COLLETTE KATRELL HOLMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2821 HUNT ST, JACKSONVILLE, FL 32254-4003
(904) 673-7212
Mailing address
2821 HUNT ST, JACKSONVILLE, FL 32254-4003
(904) 673-7212
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
AL12677
FL
Other
Enumeration date
09/08/2015
Last updated
09/08/2015
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