NPIMap

Organization Active NPI

Mi Casa Adult Living Facility Home, Inc

  • Assisted Living Facility
  • Jacksonville, FL
National Provider Identifier
1205070539
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
11548 Issued in FL
Legal business name
MI CASA ADULT LIVING FACILITY HOME, INC
Practice address
6856 Saint Augustine Rd
Jacksonville, FL 32217-2818
Phone
(904) 739-3927
Fax
(904) 448-0130
NPI assigned
Apr 30, 2009
Last updated
Jul 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Authorized official

Name
Jesus R Castillo
Title
Owner
Phone
(904) 739-3927

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 11548 FL Primary

Addresses

Primary practice location

6856 Saint Augustine Rd
Jacksonville, FL 32217-2818

Mailing address

6856 Saint Augustine Rd
Jacksonville, FL 32217-2818
Phone (904) 739-3927

National Provider Directory

National Provider Directory
Tax ID family
Mi Casa Adult Living Facility Home Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1205070539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6856 SAINT AUGUSTINE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172818",
            "telephone_number": "904-739-3927",
            "fax_number": "904-448-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6856 SAINT AUGUSTINE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172818",
            "telephone_number": "904-739-3927",
            "fax_number": "904-448-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MI CASA ADULT LIVING FACILITY HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-30",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "JESUS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-739-3927"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "11548",
            "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 Jul 20, 2023; 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.