Organization
JACKSONVILLE EXTENDED CARE, LLC
Active
Other names
Southpoint Terrace
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA J MARSH (BOOKKEEPER)
(380) 255-1054
Entity
Organization
Contact information
Practice address
4325 SOUTHPOINT BLVD, JACKSONVILLE, FL 32216-6166
(904) 245-7620
(904) 281-9956
Mailing address
4325 SOUTHPOINT BLVD, JACKSONVILLE, FL 32216-6166
(904) 245-7620
(904) 281-9956
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
130471028
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026628100
—
FL
Enumeration date
03/17/2006
Last updated
04/25/2012
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