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General NPI Number Information
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NPI Number | 1780043232
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Entity Type | Organization
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Legal Business Name | MCCALL SERVICE, INC.
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Dates
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Enumeration Date | 02/12/2016
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Last Update Date | 02/12/2016
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Provider Practice Location Address
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Address Line | 410 E PAUL RUSSELL RD
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City | TALLAHASSEE
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State | FL
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Zip | 32301-6960
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Country | US
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Telephone | 800-342-6948
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Fax | 866-961-4919
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Provider Business Mailing Address
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Address Line | 2861 COLLEGE ST
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City | JACKSONVILLE
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State | FL
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Zip | 32205-7472
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Country | US
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Telephone | 800-342-6948
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Fax | 866-961-4919
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Authorized Official
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Title or Position | OWNER/CEO
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Name | BRYAN COOKSEY
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Credential |
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Telephone | 800-342-6948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number | JB1023
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License Number State | FL
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