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General NPI Number Information
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NPI Number | 1386221638
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Entity Type | Organization
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Legal Business Name | BEST CHOICE GROUP HOME LLC
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Dates
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Enumeration Date | 03/24/2021
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 6641 BO PEEP DR N
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City | JACKSONVILLE
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State | FL
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Zip | 32210-2913
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Country | US
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Telephone | 904-299-5566
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Fax | 904-586-2001
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Provider Business Mailing Address
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Address Line | 6641 BO PEEP DR N
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City | JACKSONVILLE
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State | FL
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Zip | 32210-2913
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Country | US
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Telephone | 904-299-5566
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Fax | 904-586-2001
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Authorized Official
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Title or Position | OWNER
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Name | SELENA A STOKES
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Credential |
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Telephone | 904-299-5566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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