NPIMap

Organization Active NPI

Gulf Coast Jewish Family Services

  • Assisted Living Facility (Mental Illness)
  • St Petersburg, FL
National Provider Identifier
1194900985
Registry record updated Dec 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
License
430 Issued in FL
Legal business name
GULF COAST JEWISH FAMILY SERVICES
Practice address
3180 66TH St N
St Petersburg, FL 33710-3165
Phone
(727) 893-1661
Fax
(727) 893-1663
NPI assigned
Dec 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2007

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

Authorized official

Name
Diana J Robertson
Title
Cfo
Phone
(727) 479-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Mental Illness) 3104A0625X 430 FL Primary

Addresses

Primary practice location

3180 66TH St N
St Petersburg, FL 33710-3165

Mailing address

3180 66TH St N
St Petersburg, FL 33710-3165
Phone (727) 893-1661

Other identifiers 1

IdentifierTypeStateIssuer
430OtherFLST OF FL AHCA LICENSE

Other names 1

  • 66TH STREET GROUP HOME Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gulf Coast Jewish Family Services25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199059200000",
    "number": "1194900985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 66TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337103165",
            "telephone_number": "727-893-1661",
            "fax_number": "727-893-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 66TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337103165",
            "telephone_number": "727-893-1661",
            "fax_number": "727-893-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST JEWISH FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-31",
        "last_updated": "2007-12-31",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "727-479-1800"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST OF FL AHCA LICENSE",
            "identifier": "430",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "66TH STREET GROUP HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2007; 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.