The Jericho School for Children With Autism, Inc.

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

THE JERICHO SCHOOL FOR CHILDREN WITH AUTISM, INC.

Practice address

1351 Sprinkle Dr
Jacksonville, FL 32211-5448

Phone

(904) 744-5110

Fax

(904) 744-3443

NPI assigned

Apr 29, 2010

Last updated

Apr 29, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Angelo A. Martinez, B.C.A.B.A.NPI 1619285954

Title

Executive Director

Phone

(904) 744-5110

Specialties & licenses 1

Addresses

Tax ID family

Jericho School for Children With Autism Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Jericho School for Children With Autism, Inc.

  • Behavior Analyst
  • Jacksonville, FL
  • NPI 1104132257
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angelo Martinez, B.C.A.B.A.

  • Behavior Analyst
  • Jacksonville, FL
  • NPI 1619285954
  Authorized official Same address or phone

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

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272499200000",
    "number": "1497072482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11057",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322391057",
            "telephone_number": "904-744-5110",
            "fax_number": "904-744-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 SPRINKLE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322115448",
            "telephone_number": "904-744-5110",
            "fax_number": "904-744-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE JERICHO SCHOOL FOR CHILDREN WITH AUTISM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-29",
        "last_updated": "2010-04-29",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "ANGELO",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "904-744-5110",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "B.C.A.B.A."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmental Disabilities Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2010; 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.