MEDICARE: JONES HOUSE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	AL10406	FL

General Provider Information

NPI Number	:	1073792834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JONES HOUSE INC.

Provider Business Mailing Address
First Line	:	8115 JASMINE BLVD
Second Line	:
City	:	PORT RICHEY
State	:	FL
Zip	:	34668-3324
Country	:	US
Telephone Number	:	727-861-0715
Fax Number	:	727-862-9228

Provider Business Practice Location Address
First Line	:	8115 JASMINE BLVD
Second Line	:
City	:	PORT RICHEY
State	:	FL
Zip	:	34668-3324
Country	:	US
Telephone Number	:	727-861-0715
Fax Number	:	727-862-9228

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. LAURA LEE JONES
Credential	:
Telephone Number	:	727-861-0715

Provider Enumeration Date	:	10/29/2007
Last Update Date	:	10/29/2007

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