River Region Human Services Residential

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

RIVER REGION HUMAN SERVICES RESIDENTIAL

Practice address

2981 Parental Home Rd
Jacksonville, FL 32216-5797

Phone

(904) 899-6300

NPI assigned

Apr 12, 2022

Last updated

Apr 12, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

RIVER REGION HUMAN SERVICES INCAs reported in NPPES

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

Authorized official

Name

John Distefano

Title

Consultant

Phone

(352) 317-3214

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

River Region Human Services

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tori Lauren Heisse, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1104549419
  NPD

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649721600000",
    "number": "1497497234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 CARMICHAEL AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322072325",
            "telephone_number": "904-899-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2981 PARENTAL HOME RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165797",
            "telephone_number": "904-899-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER REGION HUMAN SERVICES RESIDENTIAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVER REGION HUMAN SERVICES INC",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A",
        "authorized_official_last_name": "DISTEFANO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CONSULTANT",
        "authorized_official_telephone_number": "352-317-3214"
    },
    "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": "DCF",
            "identifier": "1046918",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• River Hills Chiropractic Clinic Inc
• River Oaks Dental
• River Region Human Services
• River Region Human Services Inc (River Region Primary Care)
• River Region Human Services Inc
• River Town Diagnostics LLC
• River's Edge Counseling, PLLC
• River's Edge Counseling, PLLC
• Huriel A Rivera Aponte
• Mercedes Rivera Hernandez, NP

• 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 Apr 12, 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.