| Panama Youth Services, Inc | |
|
7287 Wilder Ave Jacksonville FL 32208 | |
| (904) 527-3953 | |
| (904) 683-0067 |
| Full Name | Panama Youth Services, Inc |
|---|---|
| Speciality | Counselor |
| Location | 7287 Wilder Ave, Jacksonville, Florida |
| Authorized Official Name and Position | Willie James Green (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9045273953 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Panama Youth Services, Inc 402 East 63rd Street Jacksonville FL 32208 Ph: (904) 527-3953 | Panama Youth Services, Inc 7287 Wilder Ave Jacksonville FL 32208 Ph: (904) 527-3953 |
| NPI Number | 1447533013 |
|---|---|
| Provider Enumeration Date | 09/21/2011 |
| Last Update Date | 09/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447533013 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 0416AD444101 (Florida) | Primary |
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