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Organization
WATERS EDGE OF BRADETON
Active
Organization
WATERS EDGE OF BRADETON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY JAQUES (PRESIDENT, RMI, MANAGEMENT AGENT)
(386) 774-8878
Entity
Organization
Contact information
Practice address
2015 32ND AVE W, BRADENTON, FL 34205-4505
(941) 748-7797
Mailing address
2015 32ND AVE W, BRADENTON, FL 34205-4505
(941) 748-7797
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11742
FL
Other
Enumeration date
06/12/2012
Last updated
06/12/2012
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