Organization
ETS WILLOWBROOK AT MARION
Active
Other names
Willowbrook
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON SKYLAR BURGESS (SECRETARY/TREASURER)
(614) 565-5636
Entity
Organization
Contact information
Practice address
1580 S MARION AVE, LAKE CITY, FL 32025-6913
(386) 752-4454
Mailing address
7225 DRUCILLA ST, PICKERINGTON, OH 43147-7962
(740) 964-1240
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
9909
FL
Other
Enumeration date
03/13/2018
Last updated
03/13/2018
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