Organization
JERRI'S PLACE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE G. MCGORDON (ADM. / OWNER)
(863) 934-8028
Entity
Organization
Contact information
Practice address
624 W 5TH ST, LAKELAND, FL 33805-4316
(863) 934-8028
(863) 934-8028
Mailing address
PO BOX 90154, LAKELAND, FL 33804-0154
(863) 687-6401
(863) 687-6401
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
9329
FL
Other
Enumeration date
12/11/2015
Last updated
12/11/2015
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