ST JOHN SUPPORT SERVICES, INC (NPI# 1023279478) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023279478 |
| Entity Type | Organization |
| Organization Name | ST JOHN SUPPORT SERVICES, INC |
| Practice Address |
435 Clark Rd Ste 408-3 Jacksonville FL 32218-8505 |
| Practice Telephone | 9047686116 |
| Practice Fax Number | 9047130307 |
| Mailing Telephone | 9047686116 |
| Mailing Fax Number | 9047130307 |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2008-06-18 |
| Authorized Official Name | THERESA A ISHMAN-HOLT (OWNER) |
| Authorized Official Telephone | 9047686116 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 6917585-98 | 05 | |
| FL | 6917585-96 | 05 |
| Street Address |
435 CLARK RD STE 408-3 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32218-8505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684170 | Damon Lamar Baker | Nurse Practitioner | 12533 Sampson Rd, Jacksonville, Fl, FL 32218 | 2020-09-21 |
| 1578199303 | First Coast Health Ventures, LLC | Skilled Nursing Facility | 15480 Max Leggett Parkway, Jacksonville, FL 32218 | 2020-03-12 |
| 1932679594 | Alaina Rachelle Stanley | Counselor | 11683 Spring Board Dr, Jacksonville, FL 32218 | 2018-11-27 |
| 1508345133 | War Cry Ministry Inc | Counselor | 435 Eric Ave, Jacksonville, FL 32218 | 2018-08-14 |
| 1285111484 | St Vincent's Full Service Urgent Care, LLC | Clinic/Center | 15510 Max Leggett Parkway, Ste A, Jacksonville, FL 32218 | 2018-07-20 |
| 1427544501 | Derrick Roberts | Behavioral Analyst | 11302 Forestdale Rd, Jacksonville, FL 32218 | 2018-07-02 |
| 1215420229 | Companion & Compassion LLC | Home Health | 856 Poydras Ln W, Jacksonville, FL 32218 | 2018-06-13 |
| 1952894784 | Michael Alexander Aaro | Dentist | 1840 Dunn Ave Ste 3, Jacksonville, FL 32218 | 2018-06-06 |
| 1235629445 | Melissa C Moree | Counselor | 13453 Main St. North, Suite 104, Jacksonville, FL 32218 | 2018-05-14 |
| 1861900896 | Sheila Nowlin | Physical Therapist | 1034 Dunn Ave, Jacksonville, FL 32218 | 2018-01-11 |
| Find all providers in zip 32218 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245847268 | Joshua R Grant | Day Training, Developmentally Disabled Services | 2405 Almeda St, Jacksonville, FL 32209-4632 | 2020-09-24 |
| 1760092589 | I Am Care LLC | Day Training, Developmentally Disabled Services | 6732 Gentle Oaks Dr, Jacksonville, FL 32244-3690 | 2020-08-06 |
| 1780200386 | Exceptional Comfort and Care, LLC | Day Training, Developmentally Disabled Services | 9608 Woodstone Mill Dr, Jacksonville, FL 32244-7911 | 2020-06-19 |
| 1902427370 | Endless Possibilities of Hope LLC | Day Training, Developmentally Disabled Services | 3410 Kingston St, Jacksonville, FL 32254-2338 | 2020-04-27 |
| 1144850835 | Safekeeping Support Services, LLC | Day Training, Developmentally Disabled Services | 10316 Red Tip Rd, Jacksonville, FL 32218-9132 | 2020-01-22 |
| 1174153852 | Erica C Williams | Day Training, Developmentally Disabled Services | 1026 Gallant Fox Cir S, Jacksonville, FL 32218-1955 | 2020-01-22 |
| 1336602093 | Special Methods In Life Enrichment Services LLC | Day Training, Developmentally Disabled Services | 7187 Overland Park Blvd E, Jacksonville, FL 32244-4254 | 2019-04-10 |
| 1013481720 | Dorothy Washington | Day Training, Developmentally Disabled Services | 6316 San Juan Ave Ste 41a, Jacksonville, FL 32210-2883 | 2019-01-15 |
| 1114492295 | Xiaxiang Daniels | Day Training, Developmentally Disabled Services | 5620 Collins Rd Apt 109, Jacksonville, FL 32244-6909 | 2018-10-04 |
| 1134613540 | Sunshine Support Services, LLC | Day Training, Developmentally Disabled Services | 9205 Redtail Dr, Jacksonville, FL 32222-2811 | 2018-06-19 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32218 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.