Organization
SAN JUAN RETIREMENT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELVIRA DEMDAM R.N. (ALF ADMINISTRATOR)
(904) 695-9605
Entity
Organization
Contact information
Practice address
6561 SAN JUAN AVE, JACKSONVILLE, FL 32210-2857
(904) 695-9605
(904) 693-1973
Mailing address
6561 SAN JUAN AVE, JACKSONVILLE, FL 32210-2857
(904) 695-9605
(904) 693-1973
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
9587
FL
Other
Enumeration date
01/11/2013
Last updated
01/11/2013
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