NPIMap

Organization Active NPI

Hidden Oaks Alf, Inc

  • Case Management Agency
  • Jennings, FL
National Provider Identifier
1043893704
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
HIDDEN OAKS ALF, INC
Practice address
7150 NW 22ND Dr
Jennings, FL 32053-2367
Phone
(386) 938-2097
Fax
(386) 487-0366
NPI assigned
Apr 30, 2021
Organization subpart
Yes
Parent organization
HIDDEN OAKS ALF, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Authorized official

Name
Ms. Wanda M Law, MASTERS OF EDUCATION
Title
Owner
Phone
(386) 938-2097

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

7150 NW 22ND Dr
Jennings, FL 32053-2367

Mailing address

PO Box 180
Jennings, FL 32053-0180
Phone (386) 938-2097

Other identifiers 1

IdentifierTypeStateIssuer
104310300MedicaidFL

Other names 1

  • H.O.P.E. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hidden Oaks Alf Inc5 organizations share this tax ID, including this one
Part of
Hidden Oaks Alf Inc

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620086400000",
    "number": "1043893704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 180",
            "city": "JENNINGS",
            "state": "FL",
            "postal_code": "320530180",
            "telephone_number": "386-938-2097",
            "fax_number": "386-487-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7150 NW 22ND DR",
            "city": "JENNINGS",
            "state": "FL",
            "postal_code": "320532367",
            "telephone_number": "386-938-2097",
            "fax_number": "386-487-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIDDEN OAKS ALF, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HIDDEN OAKS ALF, INC",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A",
        "authorized_official_last_name": "LAW",
        "authorized_official_first_name": "WANDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-938-2097",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MASTERS OF EDUCATION"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104310300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "H.O.P.E.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jennings, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.