Organization
ORETGA ADULT LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORY COLEMAN (EXECUTIVE DIRECTOR)
(904) 535-9302
Entity
Organization
Contact information
Practice address
5622 101ST ST, JACKSONVILLE, FL 32210-8024
(904) 535-9302
Mailing address
6817 ROJO CT, JACKSONVILLE, FL 32210-4964
(904) 535-9302
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
03/09/2016
Last updated
02/23/2026
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