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General NPI Number Information
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NPI Number | 1811380413
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Entity Type | Organization
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Legal Business Name | FLORIDA CHILDRENS INSTITUTE
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Dates
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Enumeration Date | 03/06/2015
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Last Update Date | 08/05/2015
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Provider Practice Location Address
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Address Line | 8777 SAN JOSE BLVD SUITE 801
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City | JACKSONVILLE
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State | FL
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Zip | 32217-4213
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Country | US
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Telephone | 904-374-6403
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Fax |
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Provider Business Mailing Address
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Address Line | 8777 SAN JOSE BLVD SUITE 801
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City | JACKSONVILLE
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State | FL
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Zip | 32217-4213
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Country | US
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Telephone | 904-374-6403
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CATHERINE BAKER SIMMS
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Credential | MS, BCBA
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Telephone | 904-374-6403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | H140002871873
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License Number State | FL
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