NPIMap

Organization Active NPI

Epic Community Services, Inc.

  • Substance Abuse Rehabilitation Facility
  • Saint Augustine, FL
National Provider Identifier
1104579424
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
EPIC COMMUNITY SERVICES, INC.
Practice address
3574 US Highway 1 South
Suites 106-111
Saint Augustine, FL 32086-6466
Phone
(904) 829-2273
Fax
(904) 824-0724
NPI assigned
Jan 27, 2022
Organization subpart
Yes
Parent organization
EPIC COMMUNITY SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Authorized official

Name
Mrs. Patricia Greenough
Title
Ceo
Phone
(904) 829-2273

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

3574 US Highway 1 South
Suites 106-111
Saint Augustine, FL 32086-6466

Mailing address

1400 Old Dixie Hwy
Suite a.
Saint Augustine, FL 32084-4190
Phone (904) 829-2273

Other identifiers 1

IdentifierTypeStateIssuer
070827500MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Epic Community Services Inc5 organizations share this tax ID, including this one
Part of
Epic Community Services Inc

Other organizations with this tax ID 4

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

Locations

3574 US Highway 1 S
#106111
Saint Augustine, FL 32086

1400 Old Dixie Hwy
Ste A
St Augustine, FL 32084
Phone (904) 819-1250

NPI Registry JSON

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

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1104579424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 OLD DIXIE HWY",
            "address_2": "SUITE A.",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320844190",
            "telephone_number": "904-829-2273",
            "fax_number": "904-824-0724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3574 US HIGHWAY 1 SOUTH",
            "address_2": "SUITES 106-111",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320866466",
            "telephone_number": "904-829-2273",
            "fax_number": "904-824-0724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPIC COMMUNITY SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EPIC COMMUNITY SERVICES, INC.",
        "enumeration_date": "2022-01-27",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "GREENOUGH",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-829-2273",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070827500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.