Organization
BRADFORD HOMELIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COREY LENNARD BRADFORD (ADMINISTRATOR)
(904) 237-0206
Entity
Organization
Contact information
Practice address
2335 SOUTEL DR, JACKSONVILLE, FL 32208-2171
(904) 237-0206
(904) 619-8391
Mailing address
2335 SOUTEL DR, JACKSONVILLE, FL 32208-2171
(904) 237-0206
(904) 619-8391
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12318
FL
Other
Enumeration date
07/29/2013
Last updated
07/29/2013
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