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Miss Phyllis Diane Porter
Developmentally Disabled Services Day Training Agency in Jacksonville, Florida
NPI 1952842528

Phyllis Diane Porter is a Developmentally Disabled Services Day Training Agency based in Jacksonville, FL. Phyllis Diane Porter practices in Jacksonville, FL. The NPI Number for Phyllis Diane Porter is 1952842528 and holds a License No. 000809200 (Florida).

The current practice location address for Phyllis Diane Porter is 6650 103Rd St, Jacksonville, FL and can be reached out via phone at 904-559-5434.

Location: 6650 103Rd St, Jacksonville, FL, 32238-0064
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1952842528
Provider Name
Phyllis Diane Porter
Credential
Provider Entity Type
Individual
Gender
Female
Address
6650 103Rd St, Jacksonville, FL, 32238-0064
Phone Number
904-559-5434
Fax Number
Provider Enumeration Date
03/16/2017
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
000809200 05 FL
institution
Provider Business Practice Location Address Details
Address
6650 103Rd St
City
Jacksonville
State
Florida
Zip
32210-7143
Phone Number
904-559-5434
Fax Number
person
Provider Business Mailing Address Details
Address
6650 103Rd St
City
Jacksonville
State
Florida
Zip
32210-7143
Phone Number
904-559-5434
Fax Number
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Day Training, Developmentally Disabled Services
Speciality
-
Taxonomy
251C00000X
License No.
000809200 (Florida)
Definition
These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning.
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