Organization
HOMECARE ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SATISH BADDAM (MANAGING MEMBER)
(904) 375-2672
Entity
Organization
Contact information
Practice address
1906 BELHAVEN DR, ORANGE PARK, FL 32065-7663
(904) 375-2672
(904) 375-2718
Mailing address
1906 BELHAVEN DR, ORANGE PARK, FL 32065-7663
(904) 375-2672
(904) 375-2718
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12803
FL
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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