Larue Estates

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

LARUE ESTATES

Doing business as

LaRue Estates

Practice address

8426 Delaware Ave
Jacksonville, FL 32208-2841

Phone

(904) 370-3575

Fax

(904) 683-0147

NPI assigned

Dec 4, 2017

Organization subpart

No

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

Authorized official

Name

Johnel Griggs

Title

Owner

Phone

(904) 370-3575

Specialties & licenses 6

Addresses

Other identifiers 1

Other names 1

• LaRue Estates Doing business as

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512345600000",
    "number": "1124533948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8426 DELAWARE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322082841",
            "telephone_number": "904-370-3575",
            "fax_number": "904-683-0147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8426 DELAWARE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322082841",
            "telephone_number": "904-370-3575",
            "fax_number": "904-683-0147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARUE ESTATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-04",
        "last_updated": "2017-12-04",
        "status": "A",
        "authorized_official_last_name": "GRIGGS",
        "authorized_official_first_name": "JOHNEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-370-3575"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508222076",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LaRue Estates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elle M Larson Whitaker
• Cassandra Leigh Larson
• Jan Marie Larson, M.D.
• Kari Anne Larson, R.D., L.D./N, C.L.C.
• Kristen E Larson, CCLS
• Joseph Larwa, MD, DPT
• Lydia Marie Laser, DNP, APRN, CRNA
• Jennifer Lash, LMHC
• Bria Lasher
• Meridith A Lashway, MS, RD, LD, CDE

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; 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.