Plymouth Home for Adults, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

5228 Issued in FL

Legal business name

PLYMOUTH HOME FOR ADULTS, INC.

Practice address

3225 Plymouth St
Jacksonville, FL 32205-6099

Phone

(904) 384-5796

Fax

(904) 384-1061

NPI assigned

Dec 27, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Carlos Morales

Title

Administrator

Phone

(904) 384-5796

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293408000000",
    "number": "1447554910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 PLYMOUTH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322056099",
            "telephone_number": "904-384-5796",
            "fax_number": "904-384-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 PLYMOUTH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322056099",
            "telephone_number": "904-384-5796",
            "fax_number": "904-384-1061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLYMOUTH HOME FOR ADULTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-27",
        "last_updated": "2010-12-27",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-384-5796",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "5228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140858500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marilyn Jean Plumb, COTA/L
• Aundriana Plummer
• Daniel Plummer, DPT
• Lauren Ashley Plummer, PT, DPT
• Jennifer Plut, AP
• Saw Francis PO, MD
• Charles A. Poblenz, DMD
• Theresa Garcia Poblete, PT
• Justin Podell, PT, DPT, MED, ATC
• Podiatrist on Call, LLC

• Assisted Living Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; 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.