Wiley Retirement Home

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

12207 Issued in FL

Legal business name

WILEY RETIREMENT HOME

Practice address

7024 Wiley Rd
Jacksonville, FL 32210-2736

Phone

(904) 374-2071

NPI assigned

Aug 22, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Elvira Chua Chua, RN

Title

Administrator

Phone

(904) 374-2071

Specialties & licenses 1

Addresses

Other names 1

• sanjuan retirement home Doing business as

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

{
    "created_epoch": "1345593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345593600000",
    "number": "1265780274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7024 WILEY RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322102736",
            "telephone_number": "904-374-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7024 WILEY RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322102736",
            "telephone_number": "904-374-2071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILEY RETIREMENT HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-22",
        "last_updated": "2012-08-22",
        "status": "A",
        "authorized_official_last_name": "CHUA",
        "authorized_official_first_name": "ELVIRA",
        "authorized_official_middle_name": "CHUA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-374-2071",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "12207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "sanjuan retirement home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Alexandra Wiles, MS CCC-SLP
• Amy L Wiley, M.S., CCC-SLP
• Bridgett Princess Wiley
• Carolyn Wiley
• Christie Lynne Wiley
• Kelvin James Wiley, M.D.

• Assisted Living Facility (Mental Illness) in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Assisted Living Facility (Mental Illness) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.