NPIMap

Organization Active NPI

Angelwood, Inc

  • Behavior Analyst
  • Jacksonville, FL
National Provider Identifier
1497084040
Registry record updated Dec 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-09-5888 Issued in FL
Legal business name
ANGELWOOD, INC
Practice address
4674-2 Hood Rd
Jacksonville, FL 32257-1114
Phone
(904) 288-7259
Fax
(904) 288-7260
NPI assigned
Dec 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2009

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

Authorized official

Name
Mrs. Diane Tuttle
Title
Executive Director
Phone
(904) 288-7259

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1-09-5888 FL Primary

Addresses

Primary practice location

4674-2 Hood Rd
Jacksonville, FL 32257-1114

Mailing address

PO Box 24925
Jacksonville, FL 32241-4925
Phone (904) 288-7259

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260403200000",
    "number": "1497084040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24925",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322414925",
            "telephone_number": "904-288-7259",
            "fax_number": "904-288-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4674-2 HOOD RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322571114",
            "telephone_number": "904-288-7259",
            "fax_number": "904-288-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELWOOD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-10",
        "last_updated": "2009-12-10",
        "status": "A",
        "authorized_official_last_name": "TUTTLE",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "904-288-7259",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-09-5888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; 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.