Beaded Star Eating Disorder Recovery

NPI 1053681205 - Clinic/Center - 261QM0801X

NPI Details
NPI 1053681205
Enumeration Date 01/05/2012
Last Updated 08/07/2015
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name MARILYN K MARILYN
Position OWNER
Phone (904) 241-3113
Fax (904) 513-9268
Practice Location
2380 3RD ST S
SUITE 1
JACKSONVILLE BEACH FL, 32250-4023, US
Phone (904) 241-3113
Fax (904) 513-9268
Business Location
2380 3RD ST S
SUITE 1
JACKSONVILLE BEACH FL, 32250-4023, US
Phone (904) 241-3113
Fax (904) 513-9268
Toxanomy
Taxonomy Code 261QM0801X
License State Florida
License Number ND546
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According to our database, Beaded Star Eating Disorder Recovery NPI is 1053681205, taxonomy code is 261QM0801X and license number is ND546, license state is located at Florida. Beaded Star Eating Disorder Recovery physically located at 2380 3rd St S, Jacksonville Beach FL, 32250-4023. NPI Number 1033115704 has the healthcare provider type.

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1053681205 NPI number is provided on an as is basis without warranty of any kind. 1053681205 is maintained by the National Plan & Provider Enumeration System. The contents of Beaded Star Eating Disorder Recovery are for informational purposes only.