Winchester Oaks Corporation

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

WINCHESTER OAKS CORPORATION

Practice address

871 Winchester St
Daytona Beach, FL 32114-1977

Phone

(386) 795-0353

NPI assigned

Aug 17, 2020

Last updated

Aug 17, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cicely Jackson

Title

Owner

Phone

(386) 759-0353

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597622400000",
    "number": "1407468986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 WINCHESTER ST",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141977",
            "telephone_number": "386-795-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 WINCHESTER ST",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141977",
            "telephone_number": "386-795-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINCHESTER OAKS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "CICELY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-759-0353"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "cicelydj@icloud.com",
            "affiliation": "N",
            "address_1": "871 Winchester St",
            "city": "Daytona Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321141977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patricia Wilson, DDS
• Sandra Lynn Wilson
• Tara D Wilson, MD
• Tonya Renae Wilson, DNP, PMHNP-BC
• Vance Eugene Wilson, MD
• Deborah Ann Winchock-Ebert, LMHC
• Daniel Scott Winecoff, APRN
• Shandrea Wing
• Andrew Winquist, RD
• Amber Nicole Wise, PT, DPT

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.