Provider Demographics
NPI:1073870119
Name:A&J ALF OF FLORIDA INC
Entity Type:Organization
Organization Name:A&J ALF OF FLORIDA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTTATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELLA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SPENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-245-3745
Mailing Address - Street 1:2466 RALPH AVE SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-6085
Mailing Address - Country:US
Mailing Address - Phone:754-245-3745
Mailing Address - Fax:321-729-9331
Practice Address - Street 1:2466 RALPH AVE SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-6085
Practice Address - Country:US
Practice Address - Phone:754-245-3745
Practice Address - Fax:321-729-9331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility