Organization
JACOBS LADDER FAMILY II ASSISTED LIVING II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAROLENA DECLERCQ R.N. (ADMINISTRATOR)
(321) 223-3967
Entity
Organization
Contact information
Practice address
123 BOCA CIEGA RD, COCOA BEACH, FL 32931-2601
(321) 613-2672
Mailing address
123 BOCA CIEGA RD, COCOA BEACH, FL 32931-2601
(321) 613-2672
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11844
FL
Other
Enumeration date
02/22/2011
Last updated
02/22/2011
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