| NPI | 1891353777 |
|---|---|
| Doing Business As | JACK AND ELLEN'S PLACE |
| Entity Type | Organization |
| Authorized Contact | VIELKA HAYDEE MILLS Administrator 904-382-6109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2019-06-05 |