Organization
JENLEE LIVING FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BLACK (ADMINISTRATOR)
(813) 524-6736
Entity
Organization
Contact information
Practice address
16661 CARLTON POND ST, WIMAUMA, FL 33598-2443
(813) 524-6736
(813) 479-6931
Mailing address
16661 CARLTON POND ST, WIMAUMA, FL 33598-2443
(813) 524-6736
(813) 479-6931
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
—
—
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/28/2024
Last updated
08/28/2024
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