Organization
MI CASA ADULT LIVING FACILITY HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESUS R CASTILLO (PRESIDENT)
(929) 313-1665
Entity
Organization
Contact information
Practice address
6856 SAINT AUGUSTINE RD, JACKSONVILLE, FL 32217-2818
(904) 739-3927
Mailing address
6856 SAINT AUGUSTINE RD, JACKSONVILLE, FL 32217-2818
(904) 739-3927
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
10/27/2021
Last updated
10/27/2021
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