Organization
FREMONT ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELUS GALLO PANCHO (MANAGER)
(904) 800-2653
Entity
Organization
Contact information
Practice address
2200 BAYVIEW RD, JACKSONVILLE, FL 32210-4213
(904) 800-2653
(904) 800-2656
Mailing address
2200 BAYVIEW RD, JACKSONVILLE, FL 32210-4213
(904) 800-2653
(904) 800-2656
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12549
FL
Other
Enumeration date
10/13/2014
Last updated
10/13/2014
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