NPI: 1710356647 · JACKSONVILLE, FL 32205 · Custodial Care Facility · NPI assigned 09/22/2015
| Authorized Official | COOKSEY, JENNINGS (OWNER/CEO) |
| NPI Enumeration Date | 09/22/2015 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 15 | $750.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| G9005 | Coordinated care fee, risk adjusted maintenance | 15 | 14 | $750.00 |