Organization Active NPI

Dylan's Kids. LLC

Doing business as Brain Balance Center of Jacksonville

  • Behavior Technician
  • Saint Johns, FL
National Provider Identifier
1164399028
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Legal business name
DYLAN'S KIDS. LLC
Doing business as
Brain Balance Center of Jacksonville
Practice address
155 Fountains Way Ste 13
St Johns, FL 32259-1144
Phone
(904) 822-0132
NPI assigned
Oct 23, 2025
Last updated
Oct 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Authorized official

Name
Ms. Jessica Wick
Title
Owner
Phone
(904) 822-0132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X Primary

Addresses

Primary practice location

155 Fountains Way Ste 13
St Johns, FL 32259-1144

Mailing address

155 Fountains Way Ste 13
St Johns, FL 32259-1144
Phone (904) 822-0132

Other names 1

  • Brain Balance Center of Jacksonville Doing business as

National Provider Directory

National Provider Directory

Locations

155 Fountains Way
Ste 13
St Johns, FL 32259
Phone (904) 822-0132

NPI Registry JSON

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

{
    "created_epoch": "1761177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761264000000",
    "number": "1164399028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 FOUNTAINS WAY STE 13",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322591144",
            "telephone_number": "904-822-0132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 FOUNTAINS WAY STE 13",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322591144",
            "telephone_number": "904-822-0132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYLAN'S KIDS. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-23",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A",
        "authorized_official_last_name": "WICK",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-822-0132",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brain Balance Center of Jacksonville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Johns, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; 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.