| The Arc Jacksonville, Inc. | |
|
1050 N Davis St Jacksonville FL 32209-6808 | |
| (904) 355-0155 | |
| (904) 355-9616 |
| Full Name | The Arc Jacksonville, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1050 N Davis St, Jacksonville, Florida |
| Authorized Official Name and Position | Joyce A Gibson (DIRECTOR OF FINANCE) |
| Authorized Official Contact | 9043550155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Arc Jacksonville, Inc. 1050 N Davis St Jacksonville FL 32209-6808 Ph: (904) 355-0155 | The Arc Jacksonville, Inc. 1050 N Davis St Jacksonville FL 32209-6808 Ph: (904) 355-0155 |
| NPI Number | 1558563619 |
|---|---|
| Provider Enumeration Date | 06/01/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4183096100 |
|---|---|
| Medicare Enrollment ID | O20230220002194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558563619 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Florida) | Primary |
| Provider Name | Kaitlyn Cremer Smith |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1659643930 PECOS PAC ID: 5092978270 Enrollment ID: I20120525000510 |
| Provider Name | Abigale R Such |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497351100 PECOS PAC ID: 6901214782 Enrollment ID: I20210415000935 |
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