Organization
JAST HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSE CHARLENE LOBBAN EDS (ADMINISTRATOR)
(954) 274-5934
Entity
Organization
Contact information
Practice address
6071 NW 198TH TER, HIALEAH, FL 33015-4857
(954) 274-5934
Mailing address
1841 NW 125TH TER, PEMBROKE PINES, FL 33028-2552
(954) 274-5934
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
07/09/2019
Last updated
07/09/2019
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