NPIMap

Organization Active NPI

Social Care Services, LLC

  • Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1073288759
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SOCIAL CARE SERVICES, LLC
Practice address
8833 Perimeter Park Blvd Ste 201
Jacksonville, FL 32216-1111
Phone
(904) 294-5329
Fax
(904) 485-8460
NPI assigned
Aug 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Authorized official

Name
Hydee Vanterpool, LMHC
Title
Coo
Phone
(904) 294-5329

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

8833 Perimeter Park Blvd Ste 201
Jacksonville, FL 32216-1111

Mailing address

8833 Perimeter Park Blvd Ste 201
Jacksonville, FL 32216-1111
Phone (904) 294-5329

Other identifiers 1

IdentifierTypeStateIssuer
105907000MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL PracticeFusion

National Provider Directory

National Provider Directory
Tax ID family
Social Care Services LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

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": "1628812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628812800000",
    "number": "1073288759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8833 PERIMETER PARK BLVD STE 201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161111",
            "telephone_number": "904-294-5329",
            "fax_number": "904-485-8460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8833 PERIMETER PARK BLVD STE 201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161111",
            "telephone_number": "904-294-5329",
            "fax_number": "904-485-8460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCIAL CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-13",
        "last_updated": "2021-08-13",
        "certification_date": "2021-07-14",
        "status": "A",
        "authorized_official_last_name": "VANTERPOOL",
        "authorized_official_first_name": "HYDEE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "904-294-5329",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105907000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "PracticeFusion",
            "affiliation": "N",
            "address_1": "8833 Perimeter Park Blvd Ste 201",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322161111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Aug 13, 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.