MEDICARE: JUST LIKE HOME ALF 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

General Provider Information

NPI Number	:	1164928636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUST LIKE HOME ALF INC

Provider Business Mailing Address
First Line	:	4951 RIDGEMOOR CIR
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-3154
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4951 RIDGEMOOR CIR
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-3154
Country	:	US
Telephone Number	:	727-460-8441
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TREYVOR JONES
Credential	:
Telephone Number	:	727-460-8441

Provider Enumeration Date	:	04/03/2018
Last Update Date	:	04/03/2018

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Directions to “JUST LIKE HOME ALF INC ” Practice Location

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