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General NPI Number Information
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NPI Number | 1316584675
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Entity Type | Organization
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Legal Business Name | GAINESVILLE PEER RESPITE, INC.
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Dates
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Enumeration Date | 12/05/2019
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Last Update Date | 12/05/2019
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Provider Practice Location Address
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Address Line | 728 E. UNIVERSITY AVENUE
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City | GAINESVILLE
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State | FL
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Zip | 32601
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Country | US
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Telephone | 352-278-0529
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Fax |
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Provider Business Mailing Address
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Address Line | 728 E. UNIVERSITY AVENUE
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City | GAINESVILLE
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State | FL
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Zip | 32601
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Country | US
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Telephone | 352-278-0529
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. JESSICA J HAMES
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Credential | M.A., CAP
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Telephone | 352-278-0529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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