AUTUMN VILLAGE, INC. (NPI# 1851736540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1851736540 |
Entity Type | Organization |
Organization Name | AUTUMN VILLAGE, INC. |
Practice Address |
1103 Barrs Street Jacksonville FL 32204 |
Mailing Address |
1103 Barrs St Jacksonville FL 32204-4220 |
Practice Telephone | 9043847506 |
Practice Fax Number | 9043847279 |
Mailing Telephone | 9043847506 |
Mailing Fax Number | 9043847279 |
Enumeration Date | 2013-05-08 |
Last Update Date | 2013-05-08 |
Authorized Official Name | MS. ALEXANDRA CARPENTER (DIRECTOR OF ADMISSIONS) |
Authorized Official Telephone | 9043847506 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
AL5221 | FL | Nursing & Custodial Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992929475 | Autumn Village, Inc. | Custodial Care Facility | 235 N Nc 41 Hwy, Beulaville, NC 28518-8633 | 2007-04-13 |
Street Address |
1103 BARRS STREET |
City | JACKSONVILLE |
State | FL |
Zip Code | 32204 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
Find all providers in zip 32204 |
Taxonomy Code | 3104A0625X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Assisted Living Facility |
Specialization | Assisted Living, Mental Illness |
A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548826480 | Comfort Alf LLC | Assisted Living Facility | 2122 N Myrtle Ave, Jacksonville, FL 32209-5633 | 2019-05-16 |
1194113670 | Bishop Home Care Inc | Assisted Living Facility | 16308 Magnolia Grove Way, Jacksonville, FL 32218-0116 | 2015-01-06 |
1861896284 | Stephanie's Love & Care (alf) | Assisted Living Facility | 3056 W 1st St, Jacksonville, FL 32254-2539 | 2014-10-14 |
1245643915 | Golden Retreat Shelter Care Center, Inc. | Assisted Living Facility | 4410 Moncrief Rd W, Jacksonville, FL 32209-1228 | 2014-06-10 |
1952714404 | Ivan Maldonado | Assisted Living Facility | 6320 Arlington Rd, Jacksonville, FL 32211-5430 | 2014-06-03 |
1215353370 | Arlington Adult Residential Facility, Inc. | Assisted Living Facility | 6300 Arlington Expy, Jacksonville, FL 32211-7144 | 2014-03-13 |
1679997704 | Watts Guardian Care, Inc. | Assisted Living Facility | 7217 Eudine Dr N, Jacksonville, FL 32210-2628 | 2014-02-10 |
1164868923 | Circle of Hope Inc | Assisted Living Facility | 1550 W 9th St, Jacksonville, FL 32209-5410 | 2013-05-20 |
1265780274 | Wiley Retirement Home | Assisted Living Facility | 7024 Wiley Rd, Jacksonville, FL 32210-2736 | 2012-08-22 |
1447567540 | Second Beginnings Alf | Assisted Living Facility | 7306 Maple Tree Dr, Jacksonville, FL 32277-2806 | 2010-09-10 |
Find all providers in JACKSONVILLE |
City | JACKSONVILLE |
Zip Code | 32204 |
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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.