Organization Active NPI

Ykkaeb Health - Care Center Inc.

  • Case Management Agency
  • Jacksonville, FL
National Provider Identifier
1073085825
Registry record updated Dec 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
YKKAEB HEALTH - CARE CENTER INC.
Practice address
13245 Atlantic Blvd # 4-208
Jacksonville, FL 32225-7121
Phone
(904) 203-9258
NPI assigned
Dec 18, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2018

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

Authorized official

Name
Lisa Mitchell, CCMNPI 1235553538
Title
Ceo
Phone
(904) 203-9258

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary
Home Health Agency 251E00000X
Home Health AideGroup: 193400000X SINGLE SPECIALTY GROUP 374U00000X

Addresses

Primary practice location

13245 Atlantic Blvd # 4-208
Jacksonville, FL 32225-7121

Mailing address

13245 Atlantic Blvd # 4-208
Jacksonville, FL 32225-7121
Phone (904) 203-9258

Other identifiers 1

IdentifierTypeStateIssuer
1235553538MedicaidFL

National Provider Directory

National Provider Directory

Locations

13245 Atlantic Blvd
#4208
Jacksonville, FL 32225
Phone (904) 203-9258

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1545091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545091200000",
    "number": "1073085825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13245 ATLANTIC BLVD # 4-208",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322257121",
            "telephone_number": "904-203-9258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13245 ATLANTIC BLVD # 4-208",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322257121",
            "telephone_number": "904-203-9258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YKKAEB HEALTH - CARE CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-18",
        "last_updated": "2018-12-18",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-203-9258",
        "authorized_official_credential": "CCM"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235553538",
            "state": "FL"
        }
    ],
    "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 Dec 18, 2018; 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.