IndividualActive
Audrah Hyatt
NPI 1194484295 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Orange Park, FL
Provider details
- NPI number
- 1194484295
- Entity type
- Individual
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
767 Blanding Blvd Ste 110b
Orange Park, FL 32065-5788
Phone: (803) 318-2052
Fax: (904) 203-7302
Approximate (ZIP-level) locationGet directions
Mailing address
767 Blanding Blvd Ste 110b
Orange Park, FL 32065-5788
Registry dates
- Enumerated
- 2021-12-16
- Last updated
- 2021-12-16
- Certified
- 2021-12-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.