Healthcare Provider Details
I. General information
NPI: 1265200174
Provider Name (Legal Business Name): SANTOVENIA CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/20/2023
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6856 SAINT AUGUSTINE RD
JACKSONVILLE FL
32217-2818
US
IV. Provider business mailing address
7225 TAHITI RD
JACKSONVILLE FL
32216-3282
US
V. Phone/Fax
- Phone: 904-600-3223
- Fax:
- Phone: 305-282-6625
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CLARA
MARIA
SOWERS
Title or Position: PRESIDENT
Credential:
Phone: 305-282-6625