Provider Demographics
NPI:1295077840
Name:JACKSONVILLE SCHOOL FOR AUTISM
Entity type:Organization
Organization Name:JACKSONVILLE SCHOOL FOR AUTISM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:DUNHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-732-4343
Mailing Address - Street 1:JACKSONVILLE SCHOOL FOR AUTISM
Mailing Address - Street 2:9000 SOUTHSIDE BLVD.
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256
Mailing Address - Country:US
Mailing Address - Phone:904-732-4343
Mailing Address - Fax:904-732-4344
Practice Address - Street 1:JACKSONVILLE SCHOOL FOR AUTISM
Practice Address - Street 2:9000 SOUTHSIDE BLVD.
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256
Practice Address - Country:US
Practice Address - Phone:904-732-4343
Practice Address - Fax:904-732-4344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-21
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty