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General NPI Number Information
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NPI Number | 1558863787
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Entity Type | Organization
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Legal Business Name | POSITIVE DEVELOPMENT, LLC
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Dates
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Enumeration Date | 03/04/2018
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Last Update Date | 03/04/2018
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Provider Practice Location Address
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Address Line | 3840 BELFORT RD STE 302
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City | JACKSONVILLE
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State | FL
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Zip | 32216-8210
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Country | US
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Telephone | 904-516-0913
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Fax |
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Provider Business Mailing Address
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Address Line | 3840 BELFORT RD STE 302
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City | JACKSONVILLE
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State | FL
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Zip | 32216-8210
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Country | US
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Telephone | 904-516-0913
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERICA WHITFIELD
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Credential |
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Telephone | 229-296-0626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MH11373
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License Number State | FL
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