Organization
PLEASANT LIVING FACILITY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYN WALTHOUR (ADMINISTRATOR/OWNER)
(904) 353-0501
Entity
Organization
Contact information
Practice address
1543 HILL ST, JACKSONVILLE, FL 32202-1405
(904) 353-0501
(904) 353-8621
Mailing address
1543 HILL ST, JACKSONVILLE, FL 32202-1405
(904) 353-0501
(904) 353-8621
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL9304
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
677384201
—
FL
Enumeration date
07/20/2009
Last updated
07/20/2009
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