Provider Demographics
NPI:1437791985
Name:JUBILEE ASSISTED LIVING II, LLC
Entity Type:Organization
Organization Name:JUBILEE ASSISTED LIVING II, LLC
Other - Org Name:JUBILEE ASSISTED LIVING II, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-394-9118
Mailing Address - Street 1:16791 REDWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1510
Mailing Address - Country:US
Mailing Address - Phone:954-394-9118
Mailing Address - Fax:480-685-9939
Practice Address - Street 1:16791 REDWOOD WAY
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-1510
Practice Address - Country:US
Practice Address - Phone:954-394-9118
Practice Address - Fax:480-685-9939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-16
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility