Provider Demographics
NPI:1790155950
Name:J&Y ASSISTED LIVING FOR THE AGES
Entity Type:Organization
Organization Name:J&Y ASSISTED LIVING FOR THE AGES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILHOMME
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:863-578-4800
Mailing Address - Street 1:904 LAKE MARTHA DR NE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-4278
Mailing Address - Country:US
Mailing Address - Phone:863-578-4800
Mailing Address - Fax:863-578-3017
Practice Address - Street 1:904 LAKE MARTHA DR NE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4278
Practice Address - Country:US
Practice Address - Phone:863-578-4800
Practice Address - Fax:863-578-3017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness