Organization
FRAZIER HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLYN DENISE FRAZIER (ADMINISTRATOR)
(904) 768-6741
Entity
Organization
Contact information
Practice address
4707 W MARLBORO CIR, JACKSONVILLE, FL 32206-6143
(904) 768-6741
Mailing address
4707 W MARLBORO CIR, JACKSONVILLE, FL 32206-6143
(904) 768-6741
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11707
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001691000
—
FL
Enumeration date
04/12/2011
Last updated
04/12/2011
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