NPIMap

Organization Active NPI

Friends and Adult Family Care Home

  • Adult Care Home Facility
  • Jacksonville, FL
National Provider Identifier
1194979773
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
6906276 Issued in FL
Legal business name
FRIENDS AND ADULT FAMILY CARE HOME
Practice address
764 Aqua Surf CT
Jacksonville, FL 32225-0802
Phone
(904) 554-6051
Fax
(904) 361-3235
NPI assigned
Nov 10, 2008
Last updated
Apr 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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

Authorized official

Name
Mr. Agelet St-HubertNPI 1942857230
Title
Owner/Provider
Phone
(904) 554-6051

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 6906276 FL Primary

Addresses

Primary practice location

764 Aqua Surf CT
Jacksonville, FL 32225-0802

Mailing address

764 Aqua Surf CT
Jacksonville, FL 32225-0802
Phone (904) 554-6051

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1194979773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764 AQUA SURF CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322250802",
            "telephone_number": "904-554-6051",
            "fax_number": "904-361-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 AQUA SURF CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322250802",
            "telephone_number": "904-554-6051",
            "fax_number": "904-361-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIENDS AND ADULT FAMILY CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-10",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "ST-HUBERT",
        "authorized_official_first_name": "AGELET",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "904-554-6051",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6906276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.