Organization
GRACIOUS MANNER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHENAVIAN FREDITA GOODMAN LPN (PRESIDENT)
(904) 379-4931
Entity
Organization
Contact information
Practice address
1601 DUNN AVE APT 908, JACKSONVILLE, FL 32218-4761
(904) 379-4931
Mailing address
1601 DUNN AVE APT 908, JACKSONVILLE, FL 32218-4761
(904) 379-4931
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
FL
Other
Enumeration date
07/26/2007
Last updated
07/26/2007
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