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General NPI Number Information
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NPI Number | 1962094664
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Entity Type | Organization
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Legal Business Name | THE JOURNEY FOUNDATION, INC.
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Dates
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Enumeration Date | 02/04/2021
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 910 S 8TH ST STE 205
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-3771
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Country | US
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Telephone | 904-365-0346
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Fax | 888-561-3842
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Provider Business Mailing Address
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Address Line | 910 S 8TH ST STE 205
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-3771
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Country | US
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Telephone | 904-365-0346
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Fax | 888-561-3842
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SONYA DELOATCH
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Credential |
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Telephone | 904-365-0346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State | NULL
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Taxonomy #4
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Taxonomy Code | 261QM3000X
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Taxonomy Name | Medically Fragile Infants and Children Day Care
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License Number |
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License Number State | NULL
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Taxonomy #5
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State | NULL
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Taxonomy #6
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State | NULL
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Taxonomy #7
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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 | NULL
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