Organization
ALI ANGEL'S NESI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALI ELAINE GREENE (ADMINISTRATOR)
(904) 389-3192
Entity
Organization
Contact information
Practice address
864 WYOLEN ST, JACKSONVILLE, FL 32254-2943
(904) 389-3192
Mailing address
864 WYOLEN ST, JACKSONVILLE, FL 32254-2943
(904) 389-3192
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11369
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001968700
—
FL
Enumeration date
08/23/2017
Last updated
08/23/2017
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