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General NPI Number Information
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NPI Number | 1922389907
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Entity Type | Organization
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Legal Business Name | M&J HOME CARE, INC
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Dates
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Enumeration Date | 09/02/2011
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Last Update Date | 09/02/2011
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Provider Practice Location Address
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Address Line | 5200 17TH ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33714-2706
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Country | US
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Telephone | 727-525-1906
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Fax |
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Provider Business Mailing Address
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Address Line | 5200 17TH ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33714-2706
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. JUNE MORRIS-COLLIER
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Credential |
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Telephone | 727-463-0354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | AL8249
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License Number State | FL
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