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General NPI Number Information
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NPI Number | 1649632811
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Entity Type | Organization
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Legal Business Name | ARDNAS HEALTH CARE SERVICES OF JACKSONVILLE
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Dates
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Enumeration Date | 03/25/2016
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Last Update Date | 03/25/2016
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Provider Practice Location Address
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Address Line | 2105 PARK AVE STE 25
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City | ORANGE PARK
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State | FL
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Zip | 32073-5557
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Country | US
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Telephone | 904-278-5462
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Fax | 904-215-1462
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Provider Business Mailing Address
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Address Line | 2105 PARK AVE STE 25
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City | ORANGE PARK
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State | FL
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Zip | 32073-5557
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Country | US
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Telephone | 904-278-5462
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Fax | 904-215-1462
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MISS KADIAN K MOODY
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Credential |
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Telephone | 904-278-5462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 299992515
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License Number State | FL
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