Suncoast New Options Tunis Street, LLC

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

SUNCOAST NEW OPTIONS TUNIS STREET, LLC

Practice address

4748 Tunis St
Jacksonville, FL 32205-7379

Phone

(919) 390-2980

NPI assigned

Apr 16, 2021

Organization subpart

No

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

Authorized official

Name

Mary Johns Benson

Title

Director of Billing

Phone

(336) 553-5946

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1366023822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6531 MERIDIEN DR STE 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276163213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4748 TUNIS ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322057379",
            "telephone_number": "919-390-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNCOAST NEW OPTIONS TUNIS STREET, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-16",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "BENSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JOHNS",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "336-553-5946"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual Disabilities Intermediate Care Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Intellectual Disabilities Intermediate Care Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.