Organization
SHOPJVEON LLC
Active
Parent organization
SHOPJVEON LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHOPJVEON LLC
Authorized official
MR. JAYVEON M PETERSON (OWNER)
(904) 415-7664
Entity
Organization
Contact information
Practice address
15402 HIDDEN FOAL DRIVE, JACKSONVILLE, FL 32234
(904) 415-7664
Mailing address
PO BOX 143052, GAINESVILLE, FL 32614
(904) 415-7664
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
12/10/2018
Last updated
12/10/2018
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