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Organization
UPSCALE PERSONAL CARE HOME
Active
Organization
UPSCALE PERSONAL CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REGINA HENDERSON (PRESIDENT)
(404) 693-3033
Entity
Organization
Contact information
Practice address
4375 AUTUMN RIVER ROAD, JACKSONVILLE, FL 32224
(904) 762-5477
(904) 239-3088
Mailing address
PO BOX 40673, JACKSONVILLE, FL 32203-0673
(904) 762-5477
(904) 239-3088
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12575
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AL12575
AHCA
FL
Enumeration date
07/01/2015
Last updated
07/01/2015
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