| My Peace Keeper Ii Inc. | |
|
3119 Spring Glen Rd Ste 104 Jacksonville FL 32207-5921 | |
| (980) 505-0902 | |
| (704) 919-5055 |
| Full Name | My Peace Keeper Ii Inc. |
|---|---|
| Speciality | Case Management |
| Location | 3119 Spring Glen Rd Ste 104, Jacksonville, Florida |
| Authorized Official Name and Position | Virginia Pough (DIRECTOR OF OPERATION) |
| Authorized Official Contact | 9805050902 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Peace Keeper Ii Inc. 3119 Spring Glen Rd Ste 104 Jacksonville FL 32207-5921 Ph: (980) 505-0902 | My Peace Keeper Ii Inc. 3119 Spring Glen Rd Ste 104 Jacksonville FL 32207-5921 Ph: (980) 505-0902 |
| NPI Number | 1487170759 |
|---|---|
| Provider Enumeration Date | 08/18/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487170759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
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