Organization
JRA ADULT FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH ALEX APOLLON (PRESIDENT & CEO)
(386) 931-9871
Entity
Organization
Contact information
Practice address
41 WOODLAWN DR, PALM COAST, FL 32164
(386) 931-9871
(386) 585-4962
Mailing address
41 WOODLAWN DR, PALM COAST, FL 32164-7915
(386) 931-9871
(386) 585-4962
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
6906482
FL
Other
Enumeration date
10/03/2013
Last updated
10/03/2013
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