Individual provider · Type 1 NPI

Lanisha J. Holloway

Assisted Living Facility · Jacksonville, FL

NPI number 1497039143 Active

Practice location

5022 Perrine Dr
Jacksonville, FL 32210-7859

Call (904) 772-0651 Map

Fax (904) 438-5726

Mailing address

8225 Leafcrest Dr
Jacksonville, FL 32244-7493

Specialties and licenses

TaxonomyCodeLicense
Assisted Living Facility Primary 310400000X12059 (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 1497039143

Lanisha J. Holloway's National Provider Identifier is 1497039143, issued on Sep 29, 2011. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Jacksonville, FL. The record was last updated on Oct 6, 2011.