Provider Demographics
NPI:1609203934
Name:JUBILEE OF FLORIDA ASSISTED LIVING, LLC
Entity Type:Organization
Organization Name:JUBILEE OF FLORIDA ASSISTED LIVING, LLC
Other - Org Name:JUBILEE IN THE RANCHES ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:JORDAN
Authorized Official - Last Name:SCARDEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-363-7678
Mailing Address - Street 1:13400 STIRLING RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHWEST RANCHES
Mailing Address - State:FL
Mailing Address - Zip Code:33330-3113
Mailing Address - Country:US
Mailing Address - Phone:954-380-9767
Mailing Address - Fax:
Practice Address - Street 1:13400 STIRLING RD
Practice Address - Street 2:
Practice Address - City:SOUTHWEST RANCHES
Practice Address - State:FL
Practice Address - Zip Code:33330-3113
Practice Address - Country:US
Practice Address - Phone:954-380-9767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility