Healthcare Provider Details

I. General information

NPI: 1679117618
Provider Name (Legal Business Name): THE LEAST OF THESE ADOPTION SERVICES OF FLORIDA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2019
Last Update Date: 11/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 GLENDALE LN
ORANGE PARK FL
32065-5607
US

IV. Provider business mailing address

PO BOX 440605
JACKSONVILLE FL
32222-0007
US

V. Phone/Fax

Practice location:
  • Phone: 904-866-6961
  • Fax:
Mailing address:
  • Phone: 904-866-6961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name: ANCHETTA SUTTON
Title or Position: OWNER
Credential: EDS, LCSW
Phone: 904-866-6961