PROACTIVE LIFE SKILLS LLC (NPI# 1902331382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902331382 |
| Entity Type | Organization |
| Organization Name | PROACTIVE LIFE SKILLS LLC |
| Practice Address |
13121 Atlantic Blvd Suite 200 Jacksonville FL 32225-0103 |
| Practice Telephone | 9042288358 |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2017-04-24 |
| Authorized Official Name | KELLY NODA (MANAGING DIRECTOR) |
| Authorized Official Telephone | 9042288358 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
13121 ATLANTIC BLVD SUITE 200 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32225-0103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669775037 | Pacifica Care Pllc | Clinic/Center | 13121 Atlantic Blvd, Suite 100, Jacksonville, FL 32225 | 2010-12-07 |
| 1992355051 | Kesha Devona Taylor | Behavior Technician | 13121 Atlantic Blvd, Jacksonville, FL 32225-0103 | 2019-09-19 |
| 1043798291 | Darby Ann Harris | Behavioral Analyst | 13121 Atlantic Blvd, Jacksonville, FL 32225-0103 | 2018-07-31 |
| 1356649271 | Ross Weisheit | Specialist | 13121 Atlantic Blvd, Suite 100, Jacksonville, FL 32225 | 2011-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700356367 | Ajay S Lewis | Counselor | 3010 Cobblewood Ln East, Jacksonville, FL 32225 | 2018-11-27 |
| 1467921569 | Heart To Heart LLC | Assisted Living Facility | 9378 Arlignton Expressway, Ste 218, Jacksonville, FL 32225 | 2018-11-19 |
| 1285122036 | National Vision, Inc. | Technician/Technologist | 11770 Atlantic Boulevard, Suite 300, Jacksonville, FL 32225 | 2018-04-27 |
| 1346757432 | Dedicated Senior Medical Center of Florida, LLC | Non-Pharmacy Dispensing Site | 9422 Arlington Expressway, Jacksonville, FL 32225 | 2018-01-10 |
| 1831629690 | Family First Vision Care, Pllc | Optometrist | 9398 Arlington Expresway, Suite 1, Jacksonville, FL 32225 | 2017-06-14 |
| 1437689205 | West Point Optical Group | Optometrist | 9398-1 Arlington Expresway, Jacksonville, FL 32225 | 2017-06-14 |
| 1477087815 | Naila Ortega | Dentist | 984 Chapeltown Circle N, Jacksonville, FL 32225 | 2017-04-12 |
| 1487186342 | Sidnetta Rosemond | Durable Medical Equipment & Medical Supplies | 9501 Arlington Expy Ste160, Jacksonville, FL 32225 | 2017-03-30 |
| 1669925913 | Frances Mcmiller | Counselor | 9550 Regency Square Blvd Ste 706, Jacksonville, FL 32225 | 2016-08-03 |
| 1891143103 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 1211 St. Johns Bluff Rd North, Jacksonville, FL 32225 | 2016-05-26 |
| Find all providers in zip 32225 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427632 | Sunzup Counseling and Wellness | Community/Behavioral Health | 3355 Claire Ln Apt 1116, Jacksonville, FL 32223-6662 | 2020-11-02 |
| 1063043420 | Elephant Clinic Ltd. | Community/Behavioral Health | 8 Unf Dr # 221, Jacksonville, FL 32224-7699 | 2020-02-03 |
| 1679056857 | Inspire To Rise Inc. | Community/Behavioral Health | 4603 Silverthorn Dr, Jacksonville, FL 32258-2010 | 2018-09-13 |
| 1558863787 | Positive Development, LLC | Community/Behavioral Health | 3840 Belfort Rd Ste 302, Jacksonville, FL 32216-8210 | 2018-03-04 |
| 1073012555 | Pivotal Step Services, Pllc | Community/Behavioral Health | 1106b Gum Branch Rd, Jacksonville, NC 28540-5743 | 2018-02-09 |
| 1518473594 | Werp LLC | Community/Behavioral Health | 5291 Collins Rd Lot 293, Jacksonville, FL 32244-5389 | 2017-12-28 |
| 1871007062 | National Youth Advocate Program, Inc | Community/Behavioral Health | 2200 Rosselle St, Jacksonville, FL 32204-3126 | 2017-11-27 |
| 1962913327 | Port Health Services | Community/Behavioral Health | 224 Memorial Dr Ste B, Jacksonville, NC 28546-6332 | 2017-10-12 |
| 1598282667 | B.e.h. Elderly Care LLC | Community/Behavioral Health | 5145 Timuquana Rd Apt 6, Jacksonville, FL 32210-8923 | 2017-08-29 |
| 1427598689 | Family Farms of Northeast Florida | Community/Behavioral Health | 16844 Ethel Rd, Jacksonville, FL 32218-1108 | 2017-03-06 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32225 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.