| NPI | 1679966873 |
|---|---|
| Other Name | ST. PHILOMENA ASSISTED LIVING |
| Entity Type | Organization |
| Authorized Contact | PHYLLIS LASHLEY RODGERS Owner 904-470-9965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: FL AL12632) |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2015-03-11 |