RAYNYODA JACKSON MED WAVIER AGENCY LLC
Nursing at 5 Ave, High Springs, FL

License number
Florida 6906358
Category
Nursing
Type
Assisted Living Facility
Owner
Name: MRS. RAYNYODA SHELONDA JACKSON
Title: PROVIDER
Phone: (386) 433-0350
Address
Address
1230 NW 5Th Ave, High Springs, FL 32643
National Provider ID: 1063719136
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Raynyoda Jackson Med Wavier Agency LLC

High Springs, FL

Industry:
Nonclassifiable Establishments
Doing business as:
Raynyoda Jackson Med-Waiver Agency, LLC
Registration:
Jan 31, 2008
Addresses:
1230 NW 5 Ave, High Springs, FL 32643
PO Box 2634, High Springs, FL 32655
State ID:
L08000011596
Business type:
Florida Limited Liability
Provider, Managing Member:
Raynyoda S. Jackson (Provider, Managing Member)

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