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General NPI Number Information
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NPI Number | 1730632233
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Entity Type | Organization
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Legal Business Name | JUST LIKE HOME
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Dates
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Enumeration Date | 08/01/2016
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Last Update Date | 08/01/2016
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Provider Practice Location Address
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Address Line | 5844 WINDERMERE DR
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City | JACKSONVILLE
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State | FL
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Zip | 32211-5313
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Country | US
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Telephone | 904-743-7809
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Fax | 904-503-7071
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Provider Business Mailing Address
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Address Line | 5844 WINDERMERE DR
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City | JACKSONVILLE
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State | FL
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Zip | 32211-5313
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Country | US
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Telephone | 904-743-7809
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Fax | 904-503-7071
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | NONYE JOE NDUKA
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Credential |
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Telephone | 904-716-7106
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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 | AL11856
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License Number State | FL
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