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Organization

MOOSEHAVEN INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHN CAPES (EXECUTIVE DIRECTOR)
(904) 278-1212
Entity
Organization

Contact information

Practice address
1701 PARK AVENUE, ORANGE PARK, FL 32073
(904) 278-1212
(904) 278-1294
Mailing address
1701 PARK AVENUE, ORANGE PARK, FL 32073
(904) 278-1212
(904) 278-1294

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
EXEMPT
FL

Other

Enumeration date
05/03/2007
Last updated
06/12/2008
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