Organization Active NPI

Sweet Retreat Assisted Living Facility

  • Assisted Living Facility
  • Jacksonville, FL
National Provider Identifier
1053560680
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL11394 Issued in FL
Legal business name
SWEET RETREAT ASSISTED LIVING FACILITY
Practice address
142 Cottage Ave
Jacksonville, FL 32206-3629
Phone
(904) 354-3805
Fax
(904) 354-3875
NPI assigned
Sep 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Authorized official

Name
Mr. David Sebastian Webbe, RN
Title
Administrator
Phone
(904) 476-5893

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL11394 FL Primary
Assisted Living Facility (Mental Illness) 3104A0625X AL11394 FL

Addresses

Primary practice location

142 Cottage Ave
Jacksonville, FL 32206-3629

Mailing address

142 Cottage Ave
Jacksonville, FL 32206-3629
Phone (904) 354-3805

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1053560680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 COTTAGE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322063629",
            "telephone_number": "904-354-3805",
            "fax_number": "904-354-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 COTTAGE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322063629",
            "telephone_number": "904-354-3805",
            "fax_number": "904-354-3875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEET RETREAT ASSISTED LIVING FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-18",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "WEBBE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "SEBASTIAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-476-5893",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL11394",
            "primary": true
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AL11394",
            "primary": false
        }
    ],
    "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 Sep 18, 2008; 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.