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General NPI Number Information
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NPI Number | 1487630729
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Entity Type | Organization
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Legal Business Name | ASSOCIATION FOR RETARDED CITIZENS
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Dates
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Enumeration Date | 12/19/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 86051 HAMILTON ST
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City | YULEE
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State | FL
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Zip | 32097-2711
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Country | US
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Telephone | 904-225-9355
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Fax | 904-225-9262
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Provider Business Mailing Address
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Address Line | 86051 HAMILTON ST
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City | YULEE
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State | FL
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Zip | 32097-2711
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Country | US
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Telephone | 904-225-9355
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Fax | 904-225-9262
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. FAY JOHNSON
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Credential |
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Telephone | 904-225-9355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | F002
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number | F002
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | F002
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License Number State | FL
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Taxonomy #4
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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 | 251C00000X
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License Number State | FL
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Taxonomy #5
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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 | F002
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License Number State | FL
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