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General NPI Number Information
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NPI Number | 1902257785
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Entity Type | Organization
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Legal Business Name | NORTHEAST FLORIDA AREA AGENCY ON AGING
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Dates
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Enumeration Date | 06/23/2016
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Last Update Date | 06/23/2016
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Provider Practice Location Address
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Address Line | 10688 OLD SAINT AUGUSTINE RD
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City | JACKSONVILLE
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State | FL
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Zip | 32257-1004
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Country | US
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Telephone | 904-391-6600
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Fax | 904-391-6601
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Provider Business Mailing Address
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Address Line | 10688 OLD SAINT AUGUSTINE RD
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City | JACKSONVILLE
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State | FL
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Zip | 32257-1004
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Country | US
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Telephone | 904-391-6600
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Fax | 904-391-6601
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | JALYNNE SANTIAGO
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Credential |
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Telephone | 904-391-6627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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