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1538129002

NPI Code Detail

MEDICARE: MANAGED ACCESS TO CHILD HEALTH INC

MEDICARE: MANAGED ACCESS TO CHILD HEALTH INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center
2	122300000X	Dentist
3	231H00000X	Audiologist
4	251B00000X	Case Management Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538129002
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANAGED ACCESS TO CHILD HEALTH INC

Provider Business Mailing Address
First Line	:	910 N JEFFERSON ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32209-6810
Country	:	US
Telephone Number	:	904-360-7070
Fax Number	:	904-798-4559

Provider Business Practice Location Address
First Line	:	910 N JEFFERSON ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32209-6810
Country	:	US
Telephone Number	:	904-360-7070
Fax Number	:	904-798-4559

Authorized Official
Title or Position	:	PROGRAM ADMINISTRATOR
Name	:	MRS. JANE C VENIARD
Credential	:
Telephone Number	:	904-360-7070

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	09/11/2025

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Directions to “MANAGED ACCESS TO CHILD HEALTH INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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