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Organization

CARLENE SPENCER ADULT FAMILY CARE HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CARLENE SPENCER (OWNER/CARETAKER)
(904) 766-0307
Entity
Organization

Contact information

Practice address
5120 FOXBORO RD, JACKSONVILLE, FL 32208-1027
(904) 766-0307
Mailing address
5120 FOXBORO RD, JACKSONVILLE, FL 32208-1027
(904) 766-0307

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6905980
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6931081 98
FL
Enumeration date
03/17/2009
Last updated
03/19/2009
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