Organization
WEST CENTRAL CITADEL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISMAEL ESA (PRESIDENT)
(904) 994-5106
Entity
Organization
Contact information
Practice address
10757 HAWAII DR S, JACKSONVILLE, FL 32246-8834
(904) 994-5106
Mailing address
10757 HAWAII DR S, JACKSONVILLE, FL 32246-8834
(904) 994-5106
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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