Organization
AGING GRACE LLC
Active
Other names
The Inn At Aging Grace
Organization subpart
No
Provider details
NPI number
Authorized official
COREY LENNARD BRADFORD (OWNER)
(904) 237-0206
Entity
Organization
Contact information
Practice address
2408 SOUTEL DR, JACKSONVILLE, FL 32208-5512
(904) 237-0206
Mailing address
2408 SOUTEL DR, JACKSONVILLE, FL 32208-5512
(904) 237-0206
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12669
FL
Other
Enumeration date
06/07/2015
Last updated
06/07/2015
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