Provider Demographics
NPI:1346433604
Name:PACE CENTER FOR GIRLS
Entity Type:Organization
Organization Name:PACE CENTER FOR GIRLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-421-8585
Mailing Address - Street 1:1 W ADAMS ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32202-3645
Mailing Address - Country:US
Mailing Address - Phone:904-421-8585
Mailing Address - Fax:904-421-8599
Practice Address - Street 1:1 W ADAMS ST
Practice Address - Street 2:SUITE 301
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32202-3645
Practice Address - Country:US
Practice Address - Phone:904-421-8585
Practice Address - Fax:904-421-8599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization