| Modality, Inc. | |
|
2528 Oak St Jacksonville FL 32204-4504 | |
| (904) 647-7567 | |
| (904) 647-7568 |
| Full Name | Modality, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2528 Oak St, Jacksonville, Florida |
| Authorized Official Name and Position | Kimberly Kelly (PRESIDENT/OWNER) |
| Authorized Official Contact | 9046477567 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modality, Inc. 4638 Royal Ave Jacksonville FL 32205-4952 Ph: (904) 647-7567 | Modality, Inc. 2528 Oak St Jacksonville FL 32204-4504 Ph: (904) 647-7567 |
| NPI Number | 1396161881 |
|---|---|
| Provider Enumeration Date | 03/09/2014 |
| Last Update Date | 03/09/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396161881 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH8940 (Florida) | Primary |
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