Organization
JFK GROUP HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STUART R RUSSELL (MEMBER)
(561) 863-7055
Entity
Organization
Contact information
Practice address
1643 FARMINGTON CIR, WELLINGTON, FL 33414-8923
(561) 795-9575
(561) 795-6906
Mailing address
1233 45TH ST STE A5, WEST PALM BEACH, FL 33407-2161
(561) 863-7055
(561) 863-6577
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
090752
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
682871096
—
FL
Enumeration date
09/29/2006
Last updated
06/18/2008
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