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General NPI Number Information
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NPI Number | 1952557365
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Entity Type | Organization
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Legal Business Name | PINE CASTLE INC.
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Dates
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Enumeration Date | 08/18/2008
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4911 SPRING PARK RD
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City | JACKSONVILLE
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State | FL
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Zip | 32207-7456
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Country | US
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Telephone | 904-733-2650
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Fax | 904-733-2681
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Provider Business Mailing Address
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Address Line | 4911 SPRING PARK RD
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City | JACKSONVILLE
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State | FL
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Zip | 32207-7456
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Country | US
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Telephone | 904-733-2650
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Fax | 904-733-2681
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. JONATHAN W MAY
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Credential |
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Telephone | 904-733-2650
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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 |
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License Number State | FL
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