Organization
MS. JENNIE'S PLACE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDOLPH BRACY (CEO)
(407) 274-5405
Entity
Organization
Contact information
Practice address
924 N MAGNOLIA AVE STE 320, ORLANDO, FL 32803-3850
(407) 496-6673
Mailing address
PO BOX 692286, ORLANDO, FL 32869-2286
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/27/2023
Last updated
10/27/2023
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