MARLYN ENTERPRISES OF JACKSONVILLE INC. NPI 1154430197

NPI Information

NPI: 1154430197
Provider Name: MARLYN ENTERPRISES OF JACKSONVILLE, INC.

Doing Business As: QUALITY LIFE CENTER OF JACKSONVILLE

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
11265 ALUMNI WAY
JACKSONVILLE, FL
ZIP 32246
Phone: (904) 398-2020
Get Directions

MARLYN ENTERPRISES OF JACKSONVILLE, INC. is a mental health (including community mental health center) clinic center in Jacksonville, FL. MARLYN ENTERPRISES OF JACKSONVILLE, INC. NPI is 1154430197. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Quality Life Center Of Jacksonville.

The provider's business location address is:

11265 ALUMNI WAY
JACKSONVILLE, FL
ZIP 32246-685
Phone: (904) 398-2020
Fax: (904) 724-2172

The provider's authorized official is Mark A Ulerie .
The authorized official title is Executive Director and has the following contact phone number (904) 398-2020.

The enumeration date for this NPI number is 8/30/2006 and was last updated on 9/16/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	678170596	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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