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Organization

A HOME SWEET HOME ALF OF JAX, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LANISHA J HOLLOWAY (ADMINISTRATOR/OWNER)
(904) 772-0651
Entity
Organization

Contact information

Practice address
6838 MEDELLIN CT, JACKSONVILLE, FL 32210-4922
(904) 772-0651
(904) 438-5726
Mailing address
6838 MEDELLIN CT, JACKSONVILLE, FL 32210-4922
(904) 772-0651
(904) 438-5726

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
FL

Other

Enumeration date
11/05/2015
Last updated
11/05/2015
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