Organization
J & K ASSISTED LIVING II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KETLIE ELIE ADMINISTRATOR (ADMINISTRATOR)
(321) 704-0053
Entity
Organization
Contact information
Practice address
256 BARBAROSSA RD NW, PALM BAY, FL 32907-1809
(321) 704-0053
(321) 345-4297
Mailing address
256 BARBAROSSA RD NW, PALM BAY, FL 32907-1809
(321) 704-0053
(321) 345-4297
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
10/25/2024
Last updated
10/25/2024
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