IM SULZBACHER CENTER FOR THE HOMELESS, INC
Ambulatory Health at Adams St, Jacksonville, FL

License number
Florida 6860320 00
Category
Ambulatory Health
Type
Federally Qualified Health Center (FQHC)
Owner
Name: MR. KATHLEEN PATNEAU MPH
Title: ADMINISTRATOR
Phone: (904) 394-8056
Address
Address
611 E Adams St, Jacksonville, FL 32202
National Provider ID: 1710051354
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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I.M. SULZBACHER CENTER FOR THE HOMELESS, INC

611 E Adams St, Jacksonville, FL 32202

Status:
Inactive
Doing business as:
I.M. Sulzbacher Center for The Homeless In
Inactive reason:
Cancel Adm Diss/rev
Registration:
Mar 9, 1994
Inactive since:
Oct 14, 2005
State ID:
N94000001167
Business type:
Florida Not For Profit Corporation
Treasurers:
Cindy Funkhouser, 1352 Plantation Oaks Dr, Jacksonville Beach, FL 32250 (Physical),Dan Murphy, 601 Riverside Ave, Jacksonville, FL 32204 (Physical),Lanny Felder (Treasurer), 11358 Tacito Crk Dr S, Jacksonville, FL 32223 (Physical),...
Agent:
Barber, Andy,611 E Adams St, Jacksonville, FL 32202 (Physical)
EIN:
593229898

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