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General NPI Number Information
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NPI Number | 1780408930
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Entity Type | Organization
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Legal Business Name | GREATER PURPOSE MISSIONS INC
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Dates
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Enumeration Date | 11/14/2024
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 7645 GATE PKWY STE 104-1425
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City | JACKSONVILLE
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State | FL
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Zip | 32256-2889
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Country | US
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Telephone | 904-552-9094
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Fax |
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Provider Business Mailing Address
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Address Line | 7645 GATE PKWY STE 104-1425
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City | JACKSONVILLE
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State | FL
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Zip | 32256-2889
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANGELA BROADNAX
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Credential |
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Telephone | 904-552-9094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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