M&M Supportive Living Services

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

M&M SUPPORTIVE LIVING SERVICES

Practice address

2514 Mayapple Rd E
Jacksonville, FL 32211-4268

Phone

(904) 616-8146

NPI assigned

Mar 23, 2018

Organization subpart

No

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

Authorized official

Name

Miranda Nicole PollardNPI 1376047308

Title

President

Phone

(904) 616-8146

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Miranda Nicole Pollard

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Jacksonville, FL
  • NPI 1376047308

  Community Based Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD (past) Authorized official

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521763200000",
    "number": "1447754478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2514 MAYAPPLE RD E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322114268",
            "telephone_number": "904-616-8146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2514 MAYAPPLE RD E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322114268",
            "telephone_number": "904-616-8146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M&M SUPPORTIVE LIVING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-23",
        "last_updated": "2018-03-23",
        "status": "A",
        "authorized_official_last_name": "POLLARD",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-616-8146"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• M Nan Jobson PA
• M. Khal Aboudan, MD
• M.W. Kilgore, II, M.D., P.a.
• M'Bodi LLC
• M&D Provider Services, Inc
• Naji Maaliki, MD
• Isaiah Maass
• Nyjah Maat
• Cherisse Ragasa Mabe, PA-C
• Ester S Macam, M.D.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; 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.