Organization
WASHINGTON ADULT FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ETHEL P. WASHINGTON (OWNER)
(904) 355-2031
Entity
Organization
Contact information
Practice address
1963 W 17TH ST, JACKSONVILLE, FL 32209-4775
(904) 355-2031
(904) 355-8985
Mailing address
1963 W 17TH ST, JACKSONVILLE, FL 32209-4775
(904) 355-2031
(904) 355-8985
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6905691
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142164600
—
FL
Enumeration date
11/17/2014
Last updated
11/17/2014
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