| NPI | 1902257785 |
|---|---|
| Doing Business As | ELDERSOURCE |
| Entity Type | Organization |
| Authorized Contact | JALYNNE SANTIAGO Director Of Finance 904-391-6627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2016-06-23 |