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General NPI Number Information
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NPI Number | 1891323937
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Entity Type | Organization
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Legal Business Name | FIRST COAST AGING IN PLACE SOLUTIONS INC
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Dates
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Enumeration Date | 04/01/2020
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Last Update Date | 04/01/2020
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Provider Practice Location Address
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Address Line | 13931 SPOONBILL ST N
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City | JACKSONVILLE
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State | FL
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Zip | 32224-1388
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Country | US
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Telephone | 904-832-1986
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Fax | 904-479-0197
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Provider Business Mailing Address
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Address Line | 13931 SPOONBILL ST N
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City | JACKSONVILLE
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State | FL
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Zip | 32224-1388
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Country | US
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Telephone | 904-832-1986
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JACQUELINE NDWARU
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Credential | OTD, OT/L
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Telephone | 904-832-1986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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