# PORTER'S AULT CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396904439
- **Authorized official:** MS. LASHANA MEDINA PORTER (ADMINISTRATOR)
- **Authorized official phone:** (904) 381-8962

## Contact information

- **Practice address:** 700 DAY AVE, JACKSONVILLE, FL 32205-5504
- **Practice address phone:** (904) 381-8962
- **Practice address fax:** (904) 381-8861
- **Mailing address:** 700 DAY AVE, JACKSONVILLE, FL 32205-5504
- **Mailing address phone:** (904) 381-8962
- **Mailing address fax:** (904) 381-8861

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 385H00000X | Respite Care | 9068 | FL | Yes |

## Other

- **Enumeration date:** 06/04/2008
- **Last updated:** 06/04/2008