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General NPI Number Information
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NPI Number | 1093429094
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Entity Type | Organization
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Legal Business Name | UNIQUE KIDZ ACADEMY, LLC
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Dates
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Enumeration Date | 01/13/2023
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 1344 UNIVERSITY BLVD N
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City | JACKSONVILLE
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State | FL
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Zip | 32211-5226
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Country | US
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Telephone | 904-397-3405
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Fax |
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Provider Business Mailing Address
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Address Line | 1712 KINGSLEY AVE STE 1
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City | ORANGE PARK
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State | FL
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Zip | 32073-4454
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Country | US
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Telephone | 904-397-3405
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIA FAYE PARKER
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Credential |
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Telephone | 904-397-3405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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