MEDICARE: HOPE ADULT DAYCARE

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	261QA0600X	Adult Day Care Clinic/Center	9053	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740583020
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE ADULT DAYCARE

Provider Business Mailing Address
First Line	:	1560 ROBERTS DR
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-3222
Country	:	US
Telephone Number	:	904-249-4673
Fax Number	:	904-249-4617

Provider Business Practice Location Address
First Line	:	1560 ROBERTS DR
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-3222
Country	:	US
Telephone Number	:	904-249-4673
Fax Number	:	904-249-4617

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. WINSTON DANIELS
Credential	:
Telephone Number	:	904-249-4673

Provider Enumeration Date	:	12/08/2010
Last Update Date	:	12/08/2010

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Directions to “HOPE ADULT DAYCARE ” Practice Location

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