Islf Deerwood Place Jacksonville, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

6007 Issued in FL

Legal business name

ISLF DEERWOOD PLACE JACKSONVILLE, LLC

Practice address

8700 A C Skinner Pkwy
Jacksonville, FL 32256-0836

Phone

(904) 642-7300

NPI assigned

Jun 27, 2014

Organization subpart

Yes

Parent organization

INSTITUTE FOR SENIOR LIVING OF FLORIDA INC.As reported in NPPES

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

Authorized official

Name

Howard Jaffe

Title

Director

Phone

(215) 346-6454

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Deerwood Place Doing business as

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403827200000",
    "number": "1184039232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 A C SKINNER PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560836",
            "telephone_number": "904-642-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 A C SKINNER PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560836",
            "telephone_number": "904-642-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLF DEERWOOD PLACE JACKSONVILLE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INSTITUTE FOR SENIOR LIVING OF FLORIDA INC.",
        "enumeration_date": "2014-06-27",
        "last_updated": "2014-06-27",
        "status": "A",
        "authorized_official_last_name": "JAFFE",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "215-346-6454"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "6007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010730600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deerwood Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leah Letitia Ishmael, DO
• Ishmeal Major MD LLC
• Isabel Chavely Isla Venzant
• Alen Islamovic
• Amber Lynn Isley, M.D.
• Islf-Deerwood Place-Jacksonville LLC
• Islimlipo
• Shahin Hamid Ismail, SAA
• Joel Isom, RN
• Ronnie Israel, DMD

• Assisted Living Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Assisted Living Facility in Florida

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