Provider Demographics
NPI:1528516507
Name:A A ANOINTED CARE
Entity type:Organization
Organization Name:A A ANOINTED CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OPERATER
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-517-3882
Mailing Address - Street 1:1365 HELENA ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-3325
Mailing Address - Country:US
Mailing Address - Phone:904-517-3882
Mailing Address - Fax:
Practice Address - Street 1:1365 HELENA ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-3325
Practice Address - Country:US
Practice Address - Phone:904-517-3882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services