Five S.T.a.R. Veterans Center, Inc

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

FIVE S.T.A.R. VETERANS CENTER, INC

Practice address

40 Acme St
Jacksonville, FL 32211

Phone

(904) 723-5950

Fax

(904) 723-5952

NPI assigned

Oct 5, 2012

Last updated

Jul 21, 2022By 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

Mr. Dennis Nelson Cain, LMFT

Title

Staff Therapist

Phone

(904) 723-5950

Specialties & licenses 3

Addresses

Other names 1

• Allied Veterans Center Former legal business name

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1457603060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 ACME ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322117953",
            "telephone_number": "904-723-5950",
            "fax_number": "904-723-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 ACME ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32211",
            "telephone_number": "904-723-5950",
            "fax_number": "904-723-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE S.T.A.R. VETERANS CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-05",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CAIN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "NELSON",
        "authorized_official_title_or_position": "STAFF THERAPIST",
        "authorized_official_telephone_number": "904-723-5950",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allied Veterans Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• 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 Jul 21, 2022; 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.