Prodigal Kids

LBN: Prodigal S D Corporation
Prodigal Kids is an health care organization with primary practice located at 9521 Shellie Rd Ste 13 , Jacksonville FL 32257-6174. The organization recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Pastoral, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Group Psychotherapy. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is the primary health care specialty. Prodigal S D Corporation can be contacted via phone (904) 930-4244, or through Stevens, Freda via phone (904) 930-4244.

Contact Information

Primary practice address
9521 Shellie Rd Ste 13 Jacksonville FL 32257-6174
Phone: (904) 930-4244
Fax: (954) 256-8140
Website:
Map and Directions
Authorized official contact:
Name: Stevens, Freda
Phone: (904) 930-4244

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Pastoral 101YP1600X
Behavioral Health & Social Service Providers / Professional 101YP2500X
Behavioral Health & Social Service Providers / Group Psychotherapy 103TP2701X

Profile Details

NPI number 1184153934
LBN Legal business name Prodigal S D Corporation
DBA Doing business as Prodigal Kids
Authorized official Stevens, Freda
Entity Organization
Organization subpart 1 Yes
Enumeration date Jun 6th, 2017
Last updated Jun 6th, 2017 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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