Organization
PLYMOUTH HOME FOR ADULTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLOS MORALES (ADMINISTRATOR)
(904) 384-5796
Entity
Organization
Contact information
Practice address
3225 PLYMOUTH ST, JACKSONVILLE, FL 32205-6099
(904) 384-5796
(904) 384-1061
Mailing address
3225 PLYMOUTH ST, JACKSONVILLE, FL 32205-6099
(904) 384-5796
(904) 384-1061
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
5228
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140858500
—
FL
Enumeration date
12/27/2010
Last updated
12/27/2010
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