Provider Demographics
NPI:1750883849
Name:WILLIAMS, JANIE (AFCH)
Entity type:Individual
Prefix:MRS
First Name:JANIE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:AFCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 CADILLAC DR
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-3820
Mailing Address - Country:US
Mailing Address - Phone:386-453-7966
Mailing Address - Fax:
Practice Address - Street 1:1220 CADILLAC DR
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-3820
Practice Address - Country:US
Practice Address - Phone:386-453-7966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home