Active NPI
Barak House Alf
- Assisted Living Facility
- Jacksonville, FL
National Provider Identifier
1275987695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- 12816
- Legal business name
- BARAK HOUSE ALF
- Practice address
- 1473 W 14TH St
Jacksonville, FL 32209-4942 - Phone
- (904) 353-8820
- NPI assigned
- Apr 21, 2016
- Organization subpart
- Yes
- Parent organization
- KR2 ENTERPRISES LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Steffanie Jones
- Title
- Administrator
- Phone
- (904) 353-1787
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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 12816 | FL | Primary |
| Assisted Living Facility (Mental Illness) | 3104A0625X | 12816 | FL | |
| Assisted Living Facility (Behavioral Disturbances) | 3104A0630X | 12816 | FL |
Addresses
Primary practice location
1473 W 14TH St
Jacksonville, FL 32209-4942
Mailing address
1473 W 14TH St
Jacksonville, FL 32209-4942
Phone (904) 353-8820
National Provider Directory
National Provider Directory- Part of
- KR2 Enterprises LLC
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.
-
- Assisted Living Facility
- Jacksonville, FL
- NPI 1063875003
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461196800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1461196800000",
"number": "1275987695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1473 W 14TH ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322094942",
"telephone_number": "904-353-8820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1473 W 14TH ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322094942",
"telephone_number": "904-353-8820"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BARAK HOUSE ALF",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "KR2 ENTERPRISES LLC",
"enumeration_date": "2016-04-21",
"last_updated": "2016-04-21",
"status": "A",
"authorized_official_last_name": "JONES",
"authorized_official_first_name": "STEFFANIE",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "904-353-1787"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "FL",
"license": "12816",
"primary": true
},
{
"code": "3104A0625X",
"taxonomy_group": "",
"desc": "Assisted Living Facility, Assisted Living, Mental Illness",
"state": "FL",
"license": "12816",
"primary": false
},
{
"code": "3104A0630X",
"taxonomy_group": "",
"desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
"state": "FL",
"license": "12816",
"primary": false
}
],
"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 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.