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1770016222
JAMES BLAKE
PALM COAST, FL
NPI
1770016222
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
311ZA0620X Custodial Care Facility, Adult Care Home
Enumeration Date
2017-04-11
Last Update Date
2017-04-11
Business Address
-- JAMES BLAKE
11 WHITE FEATHER LN
PALM COAST, FL 32164-3915
Phone number: 386-445-2111
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Mailing Address
-- JAMES BLAKE
11 WHITE FEATHER LN
PALM COAST, FL 32164-3915
Phone number: 386-445-2111
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