Provider Demographics
NPI:1710527270
Name:ROSECASTLE OF JACKSONVILLE LLC
Entity Type:Organization
Organization Name:ROSECASTLE OF JACKSONVILLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CHANTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:AUBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-480-1336
Mailing Address - Street 1:8929 R G SKINNER PKWY
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-9724
Mailing Address - Country:US
Mailing Address - Phone:904-513-6990
Mailing Address - Fax:
Practice Address - Street 1:8929 R G SKINNER PKWY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9724
Practice Address - Country:US
Practice Address - Phone:904-513-6990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility