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Organization

FLORIDA DEPARTMENT OF VETERANS AFFAIRS

Active
Other names
Clyde E Lassen State Veterans Nursing Home
Organization subpart
No

Provider details

NPI number
Authorized official
MS. BARBARA JEAN PAULISON PHARMD (PHARMACY MANAGER)
(904) 940-2193
Entity
Organization

Contact information

Practice address
4650 STATE ROAD 16, SAINT AUGUSTINE, FL 32092-0600
(904) 940-2193
(904) 940-0316
Mailing address
4650 STATE ROAD 16, SAINT AUGUSTINE, FL 32092-0600
(904) 940-2193
(904) 940-0316

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
PH24880
FL

Other

Enumeration date
09/17/2010
Last updated
01/22/2026
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