Individual provider · Type 1 NPI

Mary Peterson, ADMINISTRATOR

Assisted Living Facility · Jacksonville, FL

NPI number 1063221646 Active

Practice location

1622 Silver St
Jacksonville, FL 32206-4446

Call (904) 356-3022 Map

Fax (904) 350-9165

Specialties and licenses

TaxonomyCodeLicense
Assisted Living Facility Primary 310400000X8638 (FL)

Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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About NPI 1063221646

Mary Peterson, ADMINISTRATOR's National Provider Identifier is 1063221646, issued on Jan 7, 2025. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Jacksonville, FL. The record was last updated on Jan 7, 2025.