Active NPI
Ingleside Alf Home LLC
- Assisted Living Facility
- Jacksonville, FL
National Provider Identifier
1033745518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- INGLESIDE ALF HOME LLC
- Practice address
- 1433 Ingleside Ave
Jacksonville, FL 32205-7712 - Phone
- (904) 686-0102
- Fax
- (888) 374-8792
- NPI assigned
- Mar 17, 2020
- Last updated
- Feb 27, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Era Junatas McGill
- Title
- Administrator
- Phone
- (904) 686-0102
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Primary |
Addresses
Primary practice location
1433 Ingleside Ave
Jacksonville, FL 32205-7712
Mailing address
1433 Ingleside Ave
Jacksonville, FL 32205-7712
Phone (904) 686-0102
Other practice location 1
1909 Perry St
Jacksonville, FL 32206-3521
Phone (904) 686-0102
National Provider Directory
National Provider Directory- Tax ID family
- Ingleside Alf Home LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Assisted Living Facility
- Jacksonville, FL
- NPI 1770446189
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Assisted Living Facility
- Jacksonville, FL
- NPI 1770446189
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584403200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1708992000000",
"number": "1033745518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1433 INGLESIDE AVE",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322057712",
"telephone_number": "904-686-0102",
"fax_number": "888-374-8792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1433 INGLESIDE AVE",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322057712",
"telephone_number": "904-686-0102",
"fax_number": "888-374-8792"
}
],
"practiceLocations": [
{
"address_1": "1909 Perry St",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322063521",
"country_code": "US",
"telephone_number": "904-686-0102",
"fax_number": "888-374-8792",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "INGLESIDE ALF HOME LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-03-17",
"last_updated": "2024-02-27",
"certification_date": "2024-02-27",
"status": "A",
"authorized_official_last_name": "MCGILL",
"authorized_official_first_name": "ERA",
"authorized_official_middle_name": "JUNATAS",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "904-686-0102",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.