Organization
J & S ADULT LIVIVNG FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SABRINA DENISE MARSHALL (ADMINISTRATOR)
(386) 938-1336
Entity
Organization
Contact information
Practice address
1343 JOHNS ST, JENNINGS, FL 32053-3097
(386) 938-1336
(386) 938-2751
Mailing address
1343 JOHNS ST., JENNING, FL 32053
(386) 938-1336
(386) 938-2751
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL11006
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1429337
—
FL
Enumeration date
12/10/2010
Last updated
12/10/2010
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