NPI 1053617514

P.B. Support Services INC.

Organisation Case Management Agency Jacksonville, FL

Practice location

Address: 5562 Timuquana Rd STE 2, Jacksonville, FL 32210-8053
Phone: (904) 779-8918
Fax: (904) 371-9926

Authorised official

Name: Leonard D Brewer
Title: Direct / Owner
Phone: (940) 779-8918

Registered specialties (4)

Case Management Agency Primary

Agencies Taxonomy 251B00000X Licence 681937196 (FL)

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Registry record

NPI: 1053617514
Entity type: Organization
NPI issued: 1 Feb 2011
Record last updated: 1 Feb 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.