Individual provider · Type 1 NPI
Jacqueline Gale McGordon
Adult Care Home Facility · Lakeland, FL
NPI number
1063720787
Active
Practice location
1038 N Walker Ave
Lakeland, FL 33805-4276
Fax (863) 688-9776
Mailing address
828 W 2nd St
Lakeland, FL 33805-4226
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Care Home Facility Primary | 311ZA0620X | 6906490 (FL) |
Adult Care Home Facility: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
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About NPI 1063720787
Jacqueline Gale McGordon's National Provider Identifier is 1063720787, issued on Sep 15, 2010. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in Lakeland, FL. The record was last updated on Aug 23, 2011.