Organization
A PREMIER LIVING CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA AVERY (OWNER/CEO)
(904) 485-0978
Entity
Organization
Contact information
Practice address
5204 BRUNCHE DRIVE, JACKSONVILLE, FL 32209
(904) 485-0978
Mailing address
4720 SALISBURY RD, JACKSONVILLE, FL 32256-6101
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/06/2023
Last updated
06/06/2023
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