Organization
PEACHES-NA-BASKET ADULT DAY CARE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BERTHA DOLORES FLEMMING MS, NHA (EXECUTIVE DIRECTOR)
(904) 766-4993
Entity
Organization
Contact information
Practice address
2040 SOUTEL DR, JACKSONVILLE, FL 32208-2280
(904) 766-4993
(904) 713-9966
Mailing address
2040 SOUTEL DR, JACKSONVILLE, FL 32208-2280
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
672949500
—
FL
Enumeration date
06/24/2010
Last updated
09/21/2022
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