Organization
SUPPORTING INDIVIDUALS WITH DISABILITIES INC
Active
Other names
SIWDINC
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA D FREEMAN (ADMINISTRATOR)
(904) 507-9976
Entity
Organization
Contact information
Practice address
95129 SPRINGHILL RD, FERNANDINA BEACH, FL 32034-9410
(904) 507-9976
Mailing address
95129 SPRINGHILL RD, FERNANDINA BEACH, FL 32034-9410
(904) 507-9976
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
05/10/2024
Last updated
05/10/2024
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