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General NPI Number Information
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NPI Number | 1194430603
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Entity Type | Organization
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Legal Business Name | FUNCTIONAL HOMES & BODIES, LLC
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Dates
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Enumeration Date | 01/18/2023
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 10261 INNOVATION WAY
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City | JACKSONVILLE
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State | FL
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Zip | 32256-8172
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Country | US
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Telephone | 561-389-7039
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Fax |
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Provider Business Mailing Address
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Address Line | 10261 INNOVATION WAY
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City | JACKSONVILLE
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State | FL
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Zip | 32256-8172
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Country | US
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Telephone | 561-389-7039
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST/OWNER
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Name | ALEXIS CARRIE FREEBURN
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Credential | OTR/L
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Telephone | 561-389-7039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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