NPI 1235786856

Mary Imhansiemhonehi

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

Practice location

Address: 4568 Antler Hill Dr E, Jacksonville, FL 32224-8704
Phone: (386) 265-8778

Registered specialties

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

Residential Treatment Facilities Taxonomy 320900000X

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Florida →

Registry record

NPI: 1235786856
Entity type: Individual
Sex (as registered): Female
NPI issued: 19 Aug 2019
Record last updated: 19 Aug 2019

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.