Organization
LIFE CARE ST JOHNS INC
Active
Other names
Glenmoor
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND M JOHNSON (EXECUTIVE DIRECTOR)
(904) 940-4800
Entity
Organization
Contact information
Practice address
235 TOWERVIEW DR, ST AUGUSTINE, FL 32092
(904) 940-4800
(904) 940-8314
Mailing address
235 TOWERVIEW DR, ST AUGUSTINE, FL 32092
(904) 940-4800
(904) 940-8314
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
130471020
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106040
OSCAR
FL
Enumeration date
08/09/2006
Last updated
04/13/2009
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