Lavon M. Gainey

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

LAVON M. GAINEY

Practice address

11265 Alumni Way
Jacksonville, FL 32246-6685

Phone

(904) 518-6090

NPI assigned

Aug 1, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Marcus De Carvalho, M.D.

Title

Medical Director

Phone

(904) 398-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Quality Life Center of Jacksonville Doing business as

Tax ID family

Lavon M Gainey3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Lavon M. Gainey

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1093166613
  NPD tax ID
• Marlyn Enterprises of Jacksonville, Inc.

  • Community/Behavioral Health Agency
  • Orange Park, FL
  • NPI 1952074510
  NPD tax ID

Locations

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

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470009600000",
    "number": "1396298915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11265 ALUMNI WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322466685",
            "telephone_number": "904-518-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11265 ALUMNI WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322466685",
            "telephone_number": "904-518-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVON M. GAINEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-01",
        "last_updated": "2016-08-01",
        "status": "A",
        "authorized_official_last_name": "DE CARVALHO",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "904-398-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MENTAL HEALTH LICENSURE #",
            "identifier": "MH13303",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quality Life Center of Jacksonville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zenaida L Lavina, MD
• Victoria Kay Lavine, PHARMD
• Kelly A Lavista, LCSW
• Kyle Lavoie, PTA
• Lavon M. Gainey
• Louis Vincent Lavopa, M.D.
• Andrea N Law
• Zharia Natalia Law
• Devin Lawhorne
• Pei-Wen Lawing, O.D.

• Mental Illness Community Based Residential Treatment Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Illness Community Based Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.

Verify at the official NPI Registry.