Individual
JAMES BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11 WHITE FEATHER LN, PALM COAST, FL 32164-3915
(386) 445-2111
Mailing address
11 WHITE FEATHER LN, PALM COAST, FL 32164-3915
(386) 445-2111
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
04/11/2017
Last updated
04/11/2017
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