Organization
ST JOHNS COUNTY WELFARE FEDERATION
Active
Other names
Buckingham Smith Assisted Living Facility
Organization subpart
No
Provider details
NPI number
Authorized official
MARY CANESTORP ADMIN (AMINISTRATOR)
(904) 829-9315
Entity
Organization
Contact information
Practice address
169 M L KING AVE, ST AUGUSTINE, FL 32084-5139
(904) 829-9315
Mailing address
169 M L KING AVE, ST AUGUSTINE, FL 32084-5139
(904) 829-9315
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
9867
FL
Other
Enumeration date
01/25/2007
Last updated
08/22/2020
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