CARLENE SPENCER ADULT FAMILY CARE HOME
Adult Care Home
Jacksonville, Florida
Provider NPI: 1972744209
Organization Information:Organization Name: CARLENE SPENCER ADULT FAMILY CARE HOME
Practice Location:
5120 FOXBORO RD JACKSONVILLE, FL 32208 US
Tel: 904-766-0307 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
5120 FOXBORO RD JACKSONVILLE, FL 32208 US
Tel: 904-766-0307 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility Adult Care Home | FL | 6905980 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
6931081 98 | FL | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin