Contract Details
PTPN of Florida
Facility name
Advanced Care Therapy Services LLC
Provider ID
P000004412
NPI
1386901999
Tax ID
455057416
Effective Date
9/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
100.00
Location Details
Address
9860 Beach Blvd Suite C
Jacksonville, FL 32246
United States
County
Duval
Phone
9046832558 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address