PETERSON ASSISTED LIVING FACILITY NPI 1447697628

NPI Information

PETERSON ASSISTED LIVING FACILITY is an assisted living facility in Jacksonville, FL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. PETERSON ASSISTED LIVING FACILITY NPI is 1447697628. The provider is registered as an organization entity type.

The provider's business location address is:

1622 SILVER ST
JACKSONVILLE, FL
ZIP 32206-446
Phone: (904) 356-3022
Fax: (904) 350-9165

The provider's authorized official is Laverne Jackson .
The authorized official title is Director Of Operation and has the following contact phone number (904) 356-3922.

The enumeration date for this NPI number is 5/29/2013 and was last updated on 5/29/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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