Provider Demographics
NPI:1386993996
Name:PERSON CENTERED SERVICES
Entity type:Organization
Organization Name:PERSON CENTERED SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/TARGETED CARE COORDINATION
Authorized Official - Prefix:
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:GOODWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSC
Authorized Official - Phone:855-246-6394
Mailing Address - Street 1:3107 SPRING GLEN RD STE 201
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-5922
Mailing Address - Country:US
Mailing Address - Phone:855-246-6394
Mailing Address - Fax:855-246-6394
Practice Address - Street 1:3107 SPRING GLEN RD STE 201
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-5922
Practice Address - Country:US
Practice Address - Phone:855-246-6394
Practice Address - Fax:855-246-6394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management