TAMBOLINA SERVICES COMMUNITY RESIDENT HOME, INC


Address: 6285 Cranberry Ln W, Jacksonville, FL 32244-2559
Phone: 9046511310

TAMBOLINA SERVICES COMMUNITY RESIDENT HOME, INC (NPI# 1902404668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1902404668
Entity Type Organization
Organization Name TAMBOLINA SERVICES COMMUNITY RESIDENT HOME, INC
Practice Address 6285 Cranberry Ln W
Jacksonville
FL 32244-2559
Practice Telephone 9046511310
Practice Fax Number 9042400309
Mailing Telephone 9046511310
Mailing Fax Number 9042400309
Enumeration Date 2020-10-15
Last Update Date 2020-10-15
Authorized Official Name TAMBA MEDZA MOMORIE (ASSOCIATE ADMINISTRATOR)
Authorized Official Telephone 9046299922
Authorized Official Credential EDD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 310400000X Assisted Living Facility Nursing & Custodial Care Facilities

Other Provider/Organization Names

Other Name Type Code
TAMBOLINA SERVICES COMMUNITY RESIDENT HOME Former Legal Business Name - Organization

Office Location

Street Address 6285 CRANBERRY LN W
City JACKSONVILLE
State FL
Zip Code 32244-2559

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1326444340 Laurie Lynn Scheid Nurse Practitioner 7855 Argyle Forest Blvd Ste 601, Jacksonville, FL 32244 2014-11-18
1114322260 Candy Sharon Lucero Occupational Therapist 8563-2 Argyle Business Loop, Jacksonville, FL 32244 2014-10-31
1780959817 Senior Helpers In Home Supportive Care 6327 Argyle Forest Blvd, Suite 3, Jacksonville, FL 32244 2012-03-22
1093831505 Eduardo R Paat Sr. Marriage & Family Therapist 63394 Argyle Forest Blvd, Jacksonville, FL 32244 2007-03-22
1760524060 Lauren Claxton Shivers Nurse Practitioner 8351 Westport Road, Jacksonville, FL 32244 2007-02-13
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Taxonomy Information

Taxonomy Code 310400000X
Grouping Nursing & Custodial Care Facilities
Classification Assisted Living Facility

Taxonomy Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1316552284 Enhanced Universal Care Alf Assisted Living Facility 10967 Key Haven Blvd, Jacksonville, FL 32218-4463 2020-09-08
1710527270 Rosecastle of Jacksonville LLC Assisted Living Facility 8929 R G Skinner Pkwy, Jacksonville, FL 32256-9724 2020-01-13
1891353777 V & K Horizons Assisted Living Facility 7019 Mark St, Jacksonville, FL 32210-4889 2019-06-05
1144784638 Carole Stallworth Assisted Living Facility 5116 Mcmanus Dr, Jacksonville, FL 32210-6353 2019-01-29
1467921569 Heart To Heart LLC Assisted Living Facility 9378 Arlignton Expressway, Ste 218, Jacksonville, FL 32225 2018-11-19
1073090437 Lashonda Oglesby Assisted Living Facility 6313 Arlington Rd, Jacksonville, FL 32211-5423 2018-07-27
1831697218 Cortney Irene Matthews Assisted Living Facility 3109 Gilmore St, Jacksonville, FL 32205-5516 2018-01-31
1093222515 Anthem Lakes Assisted Living Facility 905 Assisi Ln, Jacksonville, FL 32233-2972 2018-01-05
1831608975 Silver Shores Living, Inc Assisted Living Facility 2317 Gilmore St, Jacksonville, FL 32204-3119 2017-09-20
1679092886 Palm Life Medical Associates Pa Assisted Living Facility 12494 Acosta Oaks Drive, Jacksonville, FL 32258 2017-09-19
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Competitor

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City JACKSONVILLE
Zip Code 32244

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Dataset Information

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.

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