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PLYMOUTH HOME FOR ADULTS INC. NPI 1447554910


NPI Information

NPI: 1447554910
Provider Name: PLYMOUTH HOME FOR ADULTS, INC.
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
3225 PLYMOUTH ST
JACKSONVILLE, FL
ZIP 32205
Phone: (904) 384-5796
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PLYMOUTH HOME FOR ADULTS, INC. is an assisted living facility in Jacksonville, FL. The provider is 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. PLYMOUTH HOME FOR ADULTS, INC. NPI is 1447554910. The provider is registered as an organization entity type.

The provider's business location address is:

3225 PLYMOUTH ST
JACKSONVILLE, FL
ZIP 32205-099
Phone: (904) 384-5796
Fax: (904) 384-1061

The provider's authorized official is Carlos Morales .
The authorized official title is Administrator and has the following contact phone number (904) 384-5796.

The enumeration date for this NPI number is 12/27/2010 and was last updated on 12/27/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living Facility5228FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1140858500MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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