Alexcia Bennett
Individual provider Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Macclenny, FL
NPI 1003637588 · NPPES record last updated Oct 18, 2024
Key facts
- NPI
- 1003637588
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- Practice address
- 505 Matecumbe CT
Macclenny, FL 32063-8832 - Phone
- (904) 414-1675
- NPI assigned
- Oct 18, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker |
172V00000X | |||
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Yes |
Addresses
Primary practice location
505 Matecumbe CT
Macclenny, FL 32063-8832
Mailing address
7645 Gate Pkwy Ste 104-1425
Jacksonville, FL 32256-2889
Other providers in Macclenny, FL
- Baker Restorative PLLC
- Latoya D Barnes
- Aron Croslin Bell
- Samitria Latrice Bell
- Deborah Lynn Bellino
- Benso Gold Dental, P.a.
- Bio-Medical Applications of Florida, Inc.
- Amanda Jean Bondie
- Janie Boulware
- Tiffany Faye Braddy
All providers in Macclenny, FL · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.