Provider Demographics
NPI:1659567600
Name:JBA SVCS INC D/B/A FOREST HILLS HOME
Entity Type:Organization
Organization Name:JBA SVCS INC D/B/A FOREST HILLS HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALF ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOCK-ACKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:ACHA ALF ADMINISTR
Authorized Official - Phone:727-934-4310
Mailing Address - Street 1:3823 PENDLEBURY DR
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-2670
Mailing Address - Country:US
Mailing Address - Phone:727-934-4310
Mailing Address - Fax:727-943-2075
Practice Address - Street 1:3672 FAIRWAY FOREST CIR
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-1001
Practice Address - Country:US
Practice Address - Phone:727-934-4310
Practice Address - Fax:727-943-2075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-23
Last Update Date:2007-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL10799310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility