Individual
JAHPHET Y GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2252 WRIGHT ST # A, FORT MYERS, FL 33916-4345
(239) 935-9247
(239) 466-0142
Mailing address
2252 WRIGHT ST # A, FORT MYERS, FL 33916-4345
(239) 935-9247
(239) 466-0142
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
6906925
FL
311ZA0620X
Adult Care Home Facility
—
—
Other
Enumeration date
04/11/2019
Last updated
10/01/2021
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