Suncoast New Options Claudia Drive, LLC

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

SUNCOAST NEW OPTIONS CLAUDIA DRIVE, LLC

Practice address

140 Claudia Dr
Jacksonville, FL 32218-4004

Phone

(919) 390-2980

NPI assigned

Apr 22, 2021

Organization subpart

No

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

Authorized official

Name

Mary Johns Benson

Title

Director of Billing

Phone

(336) 553-5946

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1528640398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6531 MERIDIEN DR STE 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276163213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 CLAUDIA DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184004",
            "telephone_number": "919-390-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNCOAST NEW OPTIONS CLAUDIA DRIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "BENSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JOHNS",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "336-553-5946"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual Disabilities Intermediate Care Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Intellectual Disabilities Intermediate Care Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.