Individual
MRS. LANISHA J HOLLOWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5022 PERRINE DR, JACKSONVILLE, FL 32210-7859
(904) 772-0651
(904) 438-5726
Mailing address
8225 LEAFCREST DR, JACKSONVILLE, FL 32244-7493
(904) 210-2685
(904) 438-5726
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
12059
FL
Other
Enumeration date
09/29/2011
Last updated
10/06/2011
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