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Organization subpart
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Provider details

NPI number
Authorized official
NONYE JOE NDUKA (ADMINISTRATION)
(904) 716-7106
Entity
Organization

Contact information

Practice address
5844 WINDERMERE DR, JACKSONVILLE, FL 32211-5313
(904) 743-7809
(904) 503-7071
Mailing address
5844 WINDERMERE DR, JACKSONVILLE, FL 32211-5313
(904) 743-7809
(904) 503-7071

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11856
FL

Other

Enumeration date
08/01/2016
Last updated
08/01/2016
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