Organization
REFFINES HOUSE
Active
Other names
Tiki Stafford
Organization subpart
No
Provider details
NPI number
Authorized official
TIKI STAFFORD (ADMINISTARTOR)
(904) 233-1090
Entity
Organization
Contact information
Practice address
523 FERN ST, JACKSONVILLE, FL 32206-6238
(904) 379-2061
Mailing address
523 FERN ST, JACKSONVILLE, FL 32206-6238
(904) 379-2061
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11189
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143051300
—
FL
Enumeration date
12/28/2017
Last updated
12/28/2017
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