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Latrena M Thomas
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Jacksonville, Florida
NPI 1760971923

Latrena M Thomas is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Jacksonville, FL. Latrena M Thomas practices in Jacksonville, FL. The NPI Number for Latrena M Thomas is 1760971923 and holds a License No. 15IV043 (Florida).

The current practice location address for Latrena M Thomas is 14091 Summer Breeze Dr E, Jacksonville, FL and can be reached out via phone at 804-502-5840 and via fax at 904-485-8541.

Location: 14091 Summer Breeze Dr E, Jacksonville, FL, 32226-7581
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1760971923
Provider Name
Latrena M Thomas
Credential
Provider Entity Type
Individual
Gender
Female
Address
14091 Summer Breeze Dr E, Jacksonville, FL, 32226-7581
Phone Number
804-502-5840
Fax Number
904-485-8541
Provider Enumeration Date
05/03/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
019341700 05 FL
institution
Provider Business Practice Location Address Details
Address
14091 Summer Breeze Dr E
City
Jacksonville
State
Florida
Zip
32218-8913
Phone Number
804-502-5840
Fax Number
904-485-8541
person
Provider Business Mailing Address Details
Address
14091 Summer Breeze Dr E
City
Jacksonville
State
Florida
Zip
32218-8913
Phone Number
804-502-5840
Fax Number
904-485-8541
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
15IV043 (Florida)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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