Healthcare Provider Details

I. General information

NPI: 1255015269
Provider Name (Legal Business Name): NEW RULEZ ACADEMY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2023
Last Update Date: 06/12/2023
Certification Date: 06/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12230 HAGAN CREEK DR W
JACKSONVILLE FL
32218-8313
US

IV. Provider business mailing address

150 BUSCH DR # 26221
JACKSONVILLE FL
32218-5547
US

V. Phone/Fax

Practice location:
  • Phone: 833-469-7859
  • Fax: 833-469-7859
Mailing address:
  • Phone: 833-469-7859
  • Fax: 833-469-7859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MS. LATOYA OATES
Title or Position: PRESIDENT
Credential: PMH
Phone: 833-469-7859