South Rehabilitation Center, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1602 Issued in FL

Legal business name

SOUTH REHABILITATION CENTER, INC.

Practice address

580 Ellis Rd S
Suite 118
Jacksonville, FL 32254-3582

Phone

(904) 423-0017

Fax

(904) 683-8169

NPI assigned

Jan 19, 2016

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Dedrix Daka

Title

Ceo

Phone

(904) 423-0017

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1003273244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 ELLIS RD S",
            "address_2": "SUITE 118",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322543582",
            "telephone_number": "904-423-0017",
            "fax_number": "904-683-8169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 ELLIS RD S",
            "address_2": "SUITE 118",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322543582",
            "telephone_number": "904-423-0017",
            "fax_number": "904-683-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH REHABILITATION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DAKA",
        "authorized_official_first_name": "DEDRIX",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-423-0017",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "1602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.