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MARINA CAMPOS

Adult Care Home

Jacksonville, Florida

Provider NPI: 1669631214

Provider Information:
 MARINA  CAMPOS 


Practice Location:
2264 DELLWOOD AVE  JACKSONVILLE, FL 32204 US
Tel: 904-384-3888  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y311ZA0620XNursing & Custodial Care Facilities
Custodial Care Facility
Adult Care Home
FL6905793

Other Provider Identifiers:

IssuerNumberStateType
142300200FL05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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