Individual
ALFRED LEE ANSLEY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3154 MELL CT, JACKSONVILLE, FL 32254-3161
(904) 563-5923
Mailing address
1321 N MAIN ST STE 3, JACKSONVILLE, FL 32206-4900
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
Other
Enumeration date
01/13/2025
Last updated
01/13/2025
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