Organization
GRANT COMMUNITY RESIDENTIAL HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAHPHET Y GRANT (AHCA PROVIDER)
(239) 935-9247
Entity
Organization
Contact information
Practice address
2252 WRIGHT STREET (A), FORT MYERS, FL 33916
(239) 935-9247
(239) 466-0142
Mailing address
2252 WRIGHT STREET (A), FORT MYERS, FL 33916
(239) 935-9247
(239) 466-0142
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
FL
Other
Enumeration date
03/02/2018
Last updated
03/02/2018
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