Organization
SAN JUAN RETIREMENT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELVIRA CHUA DEMDAM (ALF ADMINISTRATOR)
(904) 695-9605
Entity
Organization
Contact information
Practice address
6561 SAN JUAN AVE, JACKSONVILLE, FL 32210-2857
(904) 695-9605
(904) 693-1973
Mailing address
6561 SAN JUAN AVE, JACKSONVILLE, FL 32210-2857
(904) 695-9605
(904) 693-1973
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
9587
FL
Other
Enumeration date
11/29/2012
Last updated
11/29/2012
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