Jacksonville Youth Sanctuary
NPI #1992933964 in Jacksonville, Florida
Provider Information
- NPI Number
- 1992933964
- Entity Type
- Organization
- Organization Name
- Jacksonville Youth Sanctuary
- Primary Specialty
- Case Manager/Care Coordinator
- Enumeration Date
- Jun 29, 2009
- Last Updated
- Aug 12, 2009
Practice Location
- Address
- 4570 SAINT JOHNS AVE STE 3
- City
- Jacksonville
- State
- Florida
- ZIP Code
- 32210-1844
- Phone
- (904) 389-5231
Authorized Official
- Name
- JENNIFER G ROUSSET
- Title
- TARGETED CASE MANAGER
- Phone
- (904) 389-5231
Specialties & Taxonomy Codes
| Specialty |
|---|
| Case Manager/Care Coordinator |
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