NPI 1124533948

Larue Estates

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Jacksonville, FL

Practice location

Address: 8426 Delaware Ave, Jacksonville, FL 32208-2841
Phone: (904) 370-3575
Fax: (904) 683-0147

Authorised official

Name: Johnel Griggs
Title: Owner
Phone: (904) 370-3575

Registered specialties (6)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

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Home Health Agency

Agencies Taxonomy 251E00000X

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Community/Behavioral Health Agency

Agencies Taxonomy 251S00000X

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In Home Supportive Care Agency

Agencies Taxonomy 253Z00000X

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Mental Illness Community Based Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320800000X

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Child Intellectual and/or Developmental Disabilities Respite Care

Respite Care Facility Taxonomy 385HR2060X

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Registry record

NPI: 1124533948
Entity type: Organization
NPI issued: 4 Dec 2017
Record last updated: 4 Dec 2017

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.