Marlyn Enterprises of Jacksonville, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MARLYN ENTERPRISES OF JACKSONVILLE, INC.

Doing business as

Quality Life Center

Practice address

179 Wells Rd
Orange Park, FL 32073-3057

Phone

(904) 579-4614

Fax

(904) 724-2174

NPI assigned

Jul 29, 2021

Last updated

Jul 29, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

MARLYN ENTERPRISES OF JACKSONVILLE, INC.As reported in NPPES

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

Authorized official

Name

Mark Ulerie

Title

Ceo

Phone

(904) 398-2020

Specialties & licenses 1

Addresses

Other names 1

• Quality Life Center Doing business as

Tax ID family

Lavon M Gainey3 organizations share this tax ID, including this one

Part of

Lavon M Gainey

Other organizations with this tax ID 2

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

• Lavon M. Gainey

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1093166613
  NPD tax ID
• Lavon M. Gainey

  dba Quality Life Center of Jacksonville

  • Mental Illness Community Based Residential Treatment Facility
  • Jacksonville, FL
  • NPI 1396298915
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Marlyn Enterprises of Jacksonville, Inc.

  dba Quality Life Center Of Jacksonville

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jacksonville, FL
  • NPI 1154430197
  NPPES parent name

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1952074510",
    "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": "322467630",
            "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": "179 WELLS RD",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320733057",
            "telephone_number": "904-579-4614",
            "fax_number": "904-724-2174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLYN ENTERPRISES OF JACKSONVILLE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARLYN ENTERPRISES OF JACKSONVILLE, INC.",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "ULERIE",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-398-2020"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quality Life Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Haesook Marino, M.D.
• Hwang E. Marino, DMD
• Robert A. Marino, M.D.
• Mary Elizabeth Markey, MPT
• Markus Sonntag MD
• Monica Marquez Marquez, RBT
• Marivian Pantino Marquez
• Jessica L Marshall-Ayuso, DO
• Brittany Lee Martens, DNP
• Angela Martin, BCABA

• Community/Behavioral Health Agency in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Community/Behavioral Health Agency in Florida

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