Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Raynyoda Jackson Med Wavier Agency LLC

Organization Assisted Living Facility · NPI 1063719136

Raynyoda Jackson Med Wavier Agency LLC is an Assisted Living Facility in High Springs, Florida. Licensed in Florida. Registered with an NPI since 2011.

Licensed in
FL
In the registry since
2011
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1230 NW 5th Ave
High Springs, FL 32643-0418
Phone: (386) 433-0350
Fax: (385) 454-4288
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X · Licence 6906358 (FL)
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Taxonomy 320900000X

Record details

NPI number1063719136
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Raynyoda Jackson — Provider · (386) 433-0350
NPI enumeratedFebruary 25, 2011
Last updated in NPPESFebruary 25, 2011
Mailing address1230 Nw 5th Ave, Po Box 2634, High Springs, FL 32643-0418

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