1063719136 RAYNYODA JACKSON MED WAVIER AGENCY LLC
Assisted Living Facility
Active
Basic Information
- Organization Name
- RAYNYODA JACKSON MED WAVIER AGENCY LLC
- Enumeration Date
- February 25, 2011
- Last Update
- February 25, 2011
- Authorized Official
- MRS. RAYNYODA SHELONDA JACKSON
PROVIDER
Phone: (386) 433-0350
Practice Location
- Address
- 1230 NW 5TH AVE
HIGH SPRINGS, FL 326430418 - Phone
- (386) 433-0350
- Fax
- (385) 454-4288
Mailing Address
- Address
- 1230 NW 5TH AVE
PO BOX 2634
HIGH SPRINGS, FL 326430418 - Phone
- (386) 433-0350
- Fax
- (385) 454-4288
Specialties & Taxonomies
| Specialty | Code | Classification | License | State | Primary |
|---|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | N/A | N/A | No |
| Assisted Living Facility | 310400000X | Assisted Living Facility | 6906358 | FL | Primary |
Other Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 691654696 | 05 | FL | N/A |
| 691654603 | 05 | FL | N/A |
| 691654698 | 05 | FL | N/A |
| 6906358 | 01 | FL | ADULT FAMILY CARE HOME PROVIDER LICENSE NUMBER |
Frequently Asked Questions
What is RAYNYODA JACKSON MED WAVIER AGENCY LLC's NPI number?
RAYNYODA JACKSON MED WAVIER AGENCY LLC's NPI number is 1063719136.
Which doctor has NPI number 1063719136?
The doctor with NPI number 1063719136 is RAYNYODA JACKSON MED WAVIER AGENCY LLC.
What is RAYNYODA JACKSON MED WAVIER AGENCY LLC's practice address?
RAYNYODA JACKSON MED WAVIER AGENCY LLC's practice address is 1230 NW 5TH AVE, HIGH SPRINGS, FL, 326430418.
Which doctor practices at 1230 NW 5TH AVE, HIGH SPRINGS, FL, 326430418?
RAYNYODA JACKSON MED WAVIER AGENCY LLC practices at 1230 NW 5TH AVE, HIGH SPRINGS, FL, 326430418.
What is RAYNYODA JACKSON MED WAVIER AGENCY LLC's phone number?
RAYNYODA JACKSON MED WAVIER AGENCY LLC's phone number is (386) 433-0350.
Who is (386) 433-0350?
(386) 433-0350 is the phone number for RAYNYODA JACKSON MED WAVIER AGENCY LLC.
What is RAYNYODA JACKSON MED WAVIER AGENCY LLC's specialty?
RAYNYODA JACKSON MED WAVIER AGENCY LLC's specialty is Assisted Living Facility.
What type of doctor is RAYNYODA JACKSON MED WAVIER AGENCY LLC?
RAYNYODA JACKSON MED WAVIER AGENCY LLC is a Assisted Living Facility.
Is RAYNYODA JACKSON MED WAVIER AGENCY LLC a Assisted Living Facility?
Yes, RAYNYODA JACKSON MED WAVIER AGENCY LLC is a Assisted Living Facility.
Is RAYNYODA JACKSON MED WAVIER AGENCY LLC still practicing?
Yes, RAYNYODA JACKSON MED WAVIER AGENCY LLC is currently practicing.
Is RAYNYODA JACKSON MED WAVIER AGENCY LLC accepting new patients?
RAYNYODA JACKSON MED WAVIER AGENCY LLC may be accepting new patients. Please call their office at (386) 433-0350 to inquire about availability.
Is NPI 1063719136 still active?
Yes, NPI 1063719136 is currently active.
Where does RAYNYODA JACKSON MED WAVIER AGENCY LLC practice?
RAYNYODA JACKSON MED WAVIER AGENCY LLC practices in HIGH SPRINGS, FL.