Marlyn Enterprises of Jacksonville, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MARLYN ENTERPRISES OF JACKSONVILLE, INC.

Practice address

11265 Alumni Way
Jacksonville, FL 32246-6685

Phone

(904) 398-2020

Fax

(904) 724-2172

NPI assigned

Aug 30, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mark A Ulerie

Title

Executive Director

Phone

(904) 398-2020

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Quality Life Center Of Jacksonville Doing business as

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Marlyn Enterprises of Jacksonville, Inc.

  • Community/Behavioral Health Agency
  • Orange Park, FL
  • NPI 1952074510
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1154430197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11265 ALUMNI WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322466685",
            "telephone_number": "904-398-2020",
            "fax_number": "904-724-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11265 ALUMNI WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322466685",
            "telephone_number": "904-398-2020",
            "fax_number": "904-724-2172"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "941510 Old Nassauville Rd",
            "address_purpose": "LOCATION",
            "city": "Fernandina Beach",
            "state": "FL",
            "postal_code": "320347136",
            "country_code": "US",
            "telephone_number": "904-398-2020",
            "fax_number": "904-724-4172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARLYN ENTERPRISES OF JACKSONVILLE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A",
        "authorized_official_last_name": "ULERIE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "904-398-2020",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "678170596",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quality Life Center Of Jacksonville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Quality Life Center Of Jacksonville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marla D Golden DO PA
• Anthony Marler, LMHC
• Norah Ann Marler
• Ryan Anthony Marler
• Marlyn Behavioral Health Systems, Inc
• Amanda Hope Marmo, PA-C
• Cecilia Marney, MSW
• Debra Breeanna Maron, PHARMD
• Kelli Maroney
• Kristen Marquardt, APRN

• All providers in Jacksonville, FL
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.