Provider Demographics
NPI:1750048807
Name:A.J SPECIAL NEEDS DEVELOPMENT GROUP LLC
Entity Type:Organization
Organization Name:A.J SPECIAL NEEDS DEVELOPMENT GROUP LLC
Other - Org Name:A.J SPECIAL NEEDS DEVELOPMENT GROUP LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANNAKAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KENLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-961-0516
Mailing Address - Street 1:6000 METROWEST BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-7631
Mailing Address - Country:US
Mailing Address - Phone:321-961-0516
Mailing Address - Fax:
Practice Address - Street 1:6000 METROWEST BLVD STE 200
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-7631
Practice Address - Country:US
Practice Address - Phone:321-961-0516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services