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General NPI Number Information
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NPI Number | 1942665187
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Entity Type | Organization
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Legal Business Name | H2H SUPPORT SERVICES
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Dates
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Enumeration Date | 12/15/2015
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Last Update Date | 12/15/2015
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Provider Practice Location Address
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Address Line | 330 W 70TH ST
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City | JACKSONVILLE
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State | FL
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Zip | 32208-3810
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Country | US
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Telephone | 901-338-5421
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Fax | 904-379-0801
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Provider Business Mailing Address
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Address Line | 31 W ADAMS ST
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City | JACKSONVILLE
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State | FL
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Zip | 32202-3605
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Country | US
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Telephone | 901-338-5421
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Fax | 904-379-0801
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Authorized Official
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Title or Position | OWNER
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Name | HARRIETTE GARDNER
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Credential | MS
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Telephone | 901-338-5421
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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 | 1366645673
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License Number State | FL
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