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NPI Code Detail

MEDICARE: HOPE ADULT DAYCARE

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
1311ZA0620XAdult Care Home Facility9035FL

General Provider Information

NPI Number : 1972861185
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
State : FL
Zip : 32250-3222
Country : US
Telephone Number : 904-249-4673
Fax Number : 904-249-4619
Provider Business Practice Location Address
First Line : 1560 ROBERTS DRIVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32250-3222
Country : US
Telephone Number : 904-249-4673
Fax Number : 904-249-4619
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. DEBRA JEAN JOHNSON
Credential : LPN
Telephone Number : 904-249-4673
Provider Enumeration Date : 04/25/2012
Last Update Date : 04/25/2012

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Directions to “HOPE ADULT DAYCARE ” Practice Location

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