Debra's Adult Family Care Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

6906605 Issued in FL

Legal business name

DEBRA'S ADULT FAMILY CARE HOME

Practice address

3957 Victoria Lakes Dr S
Jacksonville, FL 32226-0710

Phone

(904) 379-0354

NPI assigned

Jan 22, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Debra Althea Richards

Title

Owner

Phone

(904) 379-0354

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1390348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390348800000",
    "number": "1083037329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3957 VICTORIA LAKES DR S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322260710",
            "telephone_number": "904-379-0354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3957 VICTORIA LAKES DR S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322260710",
            "telephone_number": "904-379-0354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBRA'S ADULT FAMILY CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-22",
        "last_updated": "2014-01-22",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "ALTHEA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-379-0354",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6906605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thyra Debnam
• Alicia Marie Deboe, ARNP
• Annalise M Deboef, APRN
• Debonair Salon LLC
• Brittany Marie Debord
• Alyssa Marie Debski, DO
• Joseph Decamara
• Julia Ann Decanio, MSW, LCSW
• Caitlin Christine Decara, MD
• Marcus Decarvalho, M.D.

• Adult Care Home Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Adult Care Home Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; 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.