Pacifica Augustine Road LLC
Assisted Living Facility in Jacksonville, FL. Organization (NPI-2).
NPI number1982172995
StatusActive
Last updated in NPPESNov 7, 2018
Details
- NPI
- 1982172995
- Entity type
- Organization (NPI-2)
- Legal business name
- Pacifica Augustine Road LLC
- Organization subpart
- No
- Enumeration date
- Nov 7, 2018
- Last updated
- Nov 7, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 310400000X | Assisted Living Facility | – | – | Yes |
| 311500000X | Alzheimer Center (Dementia Center) | – | – |
Other names
- Wyndham Lakes A Pacifica Senior Living Community (Doing Business As)
Practice location
10660 Old Augustine RoadJacksonville, FL 32257
Phone 914-262-4600 · Fax 904-262-1939
Mailing address
1775 Hancock StreetSuite 200
San Diego, CA 92110
Phone 619-296-9000 · Fax 619-296-9090
Authorized official
Deepak Israni
Managing Partner
6192969000
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