Jade Residence Group Home Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

JADE RESIDENCE GROUP HOME INC

Practice address

6790 NW Monoco CT
Port Saint Lucie, FL 34983-5342

Phone

(772) 873-8866

Fax

(772) 873-8866

NPI assigned

Sep 29, 2025

Last updated

Sep 29, 2025By 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

Mable Wallace

Title

Director

Phone

(772) 873-8866

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1759104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759104000000",
    "number": "1477426161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6790 NW MONOCO CT",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349835342",
            "telephone_number": "772-873-8866",
            "fax_number": "772-873-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6790 NW MONOCO CT",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349835342",
            "telephone_number": "772-873-8866",
            "fax_number": "772-873-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JADE RESIDENCE GROUP HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-29",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-28",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "MABLE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "772-873-8866"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Jacob
• Brooke Jacobs, MSW
• Chantel Tenesia Jacobs, M.D.
• Paul Edward Jacobs, DPT
• Magalie Jacques
• Anitha Jagadish, M.D.
• D'Ondre Jaggon, DC
• Jahns Errands Plus, Inc Dba Caring Hearts Senior Services
• Jaishiva PA
• James Thomas Brown, Jr., Crna, Ms, P.a.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; 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.