| Angelwood, Inc | |
|
4674-2 Hood Rd Jacksonville FL 32257-1114 | |
| (904) 288-7259 | |
| (904) 288-7260 |
| Full Name | Angelwood, Inc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 4674-2 Hood Rd, Jacksonville, Florida |
| Authorized Official Name and Position | Diane Tuttle (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9042887259 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Angelwood, Inc Po Box 24925 Jacksonville FL 32241-4925 Ph: (904) 288-7259 | Angelwood, Inc 4674-2 Hood Rd Jacksonville FL 32257-1114 Ph: (904) 288-7259 |
| NPI Number | 1497084040 |
|---|---|
| Provider Enumeration Date | 12/10/2009 |
| Last Update Date | 12/10/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497084040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-09-5888 (Florida) | Primary |
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