Organization
NORTHERN JACKSONVILLE ENTERPRISE, LLC
Active
Other names
Lanier Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NELSON ROBAINA JR. (REIMBURSEMENT)
(305) 864-9191
Entity
Organization
Contact information
Practice address
12740 LANIER RD, JACKSONVILLE, FL 32226-1704
(904) 757-0600
(904) 757-7047
Mailing address
12740 LANIER RD, JACKSONVILLE, FL 32226-1704
(904) 757-0600
(904) 757-7047
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF12880962
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0-268-003-00
—
FL
05
—
022889300
—
FL
Enumeration date
09/13/2005
Last updated
05/21/2009
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