JACKSON REEF NPI 1396398608

NPI Information

NPI: 1396398608
Provider Name: JACKSON REEF

Doing Business As: LIFE IS KETAFUL

Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
495 S NOVA RD STE 101A
ORMOND BEACH, FL
ZIP 32174
Phone: (386) 487-4673
Get Directions

JACKSON REEF is a health service clinic center in Ormond Beach, FL. JACKSON REEF NPI is 1396398608. The provider is registered as an organization entity type.
The provider Is Doing Business As Life Is Ketaful.

The provider's business location address is:

495 S NOVA RD STE 101A
ORMOND BEACH, FL
ZIP 32174-444
Phone: (386) 487-4673
Fax: (855) 829-5770

The provider's authorized official is William Louis Self .
The authorized official title is Owner and has the following contact phone number (386) 487-4673.

The enumeration date for this NPI number is 7/17/2019 and was last updated on 8/7/2020.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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