NPIMap

Organization Active NPI

Daniel Memorial Inc

  • Community/Behavioral Health Agency
  • Jacksonville, FL
National Provider Identifier
1316105091
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MH4894 Issued in FL
Legal business name
DANIEL MEMORIAL INC
Practice address
3725 Belfort Rd
Jacksonville, FL 32216-5813
Phone
(904) 296-1055
Fax
(904) 448-7700
NPI assigned
May 29, 2008
Last updated
Jul 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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

Authorized official

Name
Mr. Harry W. Williams Jr., LMHCNPI 1831413236
Title
Director
Phone
(904) 296-1055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MH4894 FL Primary

Addresses

Primary practice location

3725 Belfort Rd
Jacksonville, FL 32216-5813

Mailing address

3725 Belfort Rd
Jacksonville, FL 32216-5813
Phone (904) 296-1055

Other identifiers 1

IdentifierTypeStateIssuer
075421800MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Daniel2 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.

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1316105091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3725 BELFORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165813",
            "telephone_number": "904-296-1055",
            "fax_number": "904-448-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3725 BELFORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165813",
            "telephone_number": "904-296-1055",
            "fax_number": "904-448-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL MEMORIAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-29",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "HARRY",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "904-296-1055",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "MH4894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "075421800",
            "state": "FL"
        }
    ],
    "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 11, 2008; 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.