GOOD SHEPHERD RETIREMENT LLC NPI 1770238669

NPI Information

NPI: 1770238669
Provider Name: GOOD SHEPHERD RETIREMENT LLC
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
1769 LANE AVE S
JACKSONVILLE, FL
ZIP 32210
Phone: (904) 343-0564
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GOOD SHEPHERD RETIREMENT LLC 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. GOOD SHEPHERD RETIREMENT LLC NPI is 1770238669. The provider is registered as an organization entity type.

The provider's business location address is:

1769 LANE AVE S
JACKSONVILLE, FL
ZIP 32210-334
Phone: (904) 343-0564

The provider's authorized official is Chester Capuyan .
The authorized official title is Owner and has the following contact phone number (904) 343-0564.

The enumeration date for this NPI number is 2/18/2022 and was last updated on 2/18/2022.

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
1	310400000X	Assisted Living Facility				Yes

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

NPI Synchronization or Removal

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