PEACHES-NA-BASKET ADULT DAY CARE CENTER, INC. (NPI# 1811208804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811208804 |
| Entity Type | Organization |
| Organization Name | PEACHES-NA-BASKET ADULT DAY CARE CENTER, INC. |
| Practice Address |
2040 Soutel Dr Jacksonville FL 32208-2280 |
| Practice Telephone | 9047664993 |
| Practice Fax Number | 9047139966 |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2010-06-24 |
| Authorized Official Name | MS. B. DOLORES FLEMMING (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9047664993 |
| Authorized Official Credential | MS, NHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311500000X | Alzheimer Center (Dementia Center) | 8159 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 672949500 | 05 |
| Street Address |
2040 SOUTEL DR |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32208-2280 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841548898 | Peachesnabasket Adult Health Services | Point of Service | 2040 Soutel Dr, Jacksonville, FL 32208-2280 | 2012-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245845379 | Lameka Williams | Adult Companion | 6854 Cartier Cir, Jacksonville, FL 32208 | 2020-09-15 |
| 1386173722 | Danielle Mathews | Home Health | 6824 Barberie St., Jacksonville, FL 32208 | 2017-06-08 |
| 1063957520 | Crystal Tramaine Simmons | Licensed Practical Nurse | 3190 Sedona Trl, Jacksonville, FL 32208 | 2016-12-19 |
| 1508316084 | Melissa Angel | Emergency Medical Technician, Basic | 3701 Winton Drive, Jacksonville, FL 32208 | 2016-10-10 |
| 1093176828 | Stephanie Fears | Chore Provider | 5910 Droad St, Jacksonville, FL 32208 | 2016-03-07 |
| 1841676558 | Elizabeth Ann Miller | Social Worker | 1255 Lila Ave, Jacksonville, FL 32208 | 2015-08-04 |
| 1861877698 | Sara Castro | Counselor | 1110 Edgewood Ave West, Jacksonville, FL 32208 | 2015-07-22 |
| 1215352703 | Luther Quarles Iv | Family Medicine | 1760 Edgewood Ave W Ste A&b, Jacksonville, FL 32208 | 2014-02-20 |
| 1356776348 | Top of The Line Mobile Service | Durable Medical Equipment & Medical Supplies | 2252 4th Avenue, Jacksonville, FL 32208 | 2013-09-09 |
| 1437419124 | Carmelita Patrice Rowell | Specialist | 2255 Soutel Dr, Jacksonville, FL 32208 | 2012-05-29 |
| Find all providers in zip 32208 | ||||
| Taxonomy Code | 311500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Alzheimer Center (Dementia Center) |
| A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer’s Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982172995 | Pacifica Augustine Road LLC | Alzheimer Center (Dementia Center) | 10660 Old Augustine Road, Jacksonville, FL 32257 | 2018-11-07 |
| 1780160192 | Ganesh Healthcare of Jax LLC | Alzheimer Center (Dementia Center) | 644 Cesery Blvd Ste 150, Jacksonville, FL 32211 | 2018-07-18 |
| 1184832107 | Esc New Port Richey, LLCemeritus Properties Ngh LLC | Alzheimer Center (Dementia Center) | 6895 Belfort Oaks Pl, Jacksonville, FL 32216-6242 | 2007-05-21 |
| 1912920174 | Liberty Healthcare Group, LLC | Alzheimer Center (Dementia Center) | 3045 Henderson Dr, Jacksonville, NC 28546-5247 | 2006-07-26 |
| 1053656199 | San Juan Retirement Home | Alzheimer Center (Dementia Center) | 6561 San Juan Ave, Jacksonville, FL 32210-2857 | 2012-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114527744 | Somh Boca Raton Operating, LLC | Alzheimer Center (Dementia Center) | 21865 Ponderosa Dr, Boca Raton, FL 33428-6215 | 2020-11-01 |
| 1417556978 | Mh Gentry Park Al Operating, LLC | Alzheimer Center (Dementia Center) | 3201 Center Pointe Dr, Orlando, FL 32825-6323 | 2020-10-25 |
| 1144876327 | Immaculate Adult Day Care LLC | Alzheimer Center (Dementia Center) | 234 Willard St Ste A, Cocoa, FL 32922-7984 | 2019-08-14 |
| 1689152910 | American Eagle Leesburg Mc LLC | Alzheimer Center (Dementia Center) | 710 S Lake St, Leesburg, FL 34748-7327 | 2018-07-30 |
| 1518445857 | American Eagle Venice Island LLC | Alzheimer Center (Dementia Center) | 1200 Avenida Del Circo, Venice, FL 34285 | 2018-07-30 |
| 1861917171 | Memory Lane Cottage At Oviedo, LLC | Alzheimer Center (Dementia Center) | 450 Oviedo Blvd, Oviedo, FL 32765-3508 | 2017-08-08 |
| 1891219119 | Waveney Gittens-williams | Alzheimer Center (Dementia Center) | 3706 W. Idle Wild Cir #203, Tampa, FL 33614 | 2017-07-28 |
| 1831640697 | Senior Living Iv Sun City, LLC | Alzheimer Center (Dementia Center) | 1320 33rd St Se, Ruskin, FL 33573-4904 | 2016-10-17 |
| 1881144699 | Mease Manor, Inc. | Alzheimer Center (Dementia Center) | 603 Virginia St, Dunedin, FL 34698-6613 | 2016-10-05 |
| 1396196861 | Excel Hospitality Group, LLC | Alzheimer Center (Dementia Center) | 15000 N Highway 441, Eustis, FL 32726-6589 | 2016-06-27 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 32208 |
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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.