Organization
FLORIDA SOUTHERN ASSISTED LIVING LLC
Active
Other names
Ingleside Retirement Home
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE WOODRUFF (CEO)
(843) 571-5366
Entity
Organization
Contact information
Practice address
1433 INGLESIDE AVE, JACKSONVILLE, FL 32205-7712
(843) 571-5399
(843) 571-5659
Mailing address
1019 PHYSICIANS DR, CHARLESTON, SC 29414-5746
(843) 571-5366
(843) 571-5659
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
03/19/2013
Last updated
03/19/2013
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