Provider Demographics
NPI:1518309319
Name:MARTHA'S ADULT DAYCARE & SERVICES, INC.
Entity Type:Organization
Organization Name:MARTHA'S ADULT DAYCARE & SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:MARTHA
Authorized Official - Last Name:JONES-WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-766-0496
Mailing Address - Street 1:8668 LEM TURNER RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-2667
Mailing Address - Country:US
Mailing Address - Phone:904-766-0496
Mailing Address - Fax:
Practice Address - Street 1:1680 DUNN AVE. UNITS 23, 24, 25
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-4782
Practice Address - Country:US
Practice Address - Phone:904-766-0496
Practice Address - Fax:904-766-0497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-22
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9249261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care