IHS OF FLORIDA AT JACKSONVILLE INC
Nursing at Fouraker Rd, Jacksonville, FL

License number
Florida SNF1087096
Category
Nursing
Type
Skilled Nursing Facility
Owner
Name: MR. BRIAN REYNOLDS
Title: CEO
Phone: (410) 513-8738
Address
Address
1650 Fouraker Rd, Jacksonville, FL 32221
National Provider ID: 1033194279
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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IHS OF FLORIDA AT JACKSONVILLE, INC

Jacksonville, FL  -  Baltimore, MD

Registration:
Apr 5, 1999
Addresses:
1650 Fouraker Rd, Jacksonville, FL 32221 (Physical)
1423 Clarkview Rd SUITE 500, Baltimore, MD 21209 (Mailing)
State ID:
F99000001772
Business type:
Foreign Profit Corporation
Entity State:
DE
S:
Timothy Nicholson, 1423 Clarkview Rd, Baltimore, MD 21209 (Physical),John Poole, 1423 Clarkview Rd, Baltimore, MD 21209 (Physical),Brian K Reynolds, 1423 Clarkview Rd, Baltimore, MD 21209 (Physical)
Agent:
C T Corporation System,1200 S Pne Is Rd, Fort Lauderdale, FL 33324 (Physical)
FEI/EIN:
52-2155335

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