MARDELL JACKSON

LAKE CITY, FL
NPI1598247009
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy310400000X Assisted Living Facility
Enumeration Date2018-08-30
Last Update Date2018-08-30
Business Address
MARDELL JACKSON
197 NW GWEN LAKE AVE
LAKE CITY, FL 32055-3711
Phone number: 386-697-9425
Mailing Address
MARDELL JACKSON
PO BOX 2666
LAKE CITY, FL 32056-2666
Phone number: 386-697-9425
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