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General NPI Number Information
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NPI Number | 1639578933
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Entity Type | Organization
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Legal Business Name | NOBLE GARDENS OF JACKSONVILLE, LLC
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Dates
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Enumeration Date | 08/22/2014
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Last Update Date | 08/22/2014
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Provider Practice Location Address
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Address Line | 7024 WILEY RD
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City | JACKSONVILLE
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State | FL
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Zip | 32210-2736
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Country | US
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Telephone | 904-374-2071
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Fax | 904-374-2236
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Provider Business Mailing Address
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Address Line | 7024 WILEY RD
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City | JACKSONVILLE
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State | FL
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Zip | 32210-2736
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Country | US
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Telephone | 904-374-2071
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Fax | 904-374-2236
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | LALAINE F CATE
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Credential | GRADUATE
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Telephone | 904-374-2071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL12207
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License Number State | FL
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