Orange Park Assisted Living Facility, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12390 Issued in FL

Legal business name

ORANGE PARK ASSISTED LIVING FACILITY, INC.

Practice address

2485 Ridgecrest Ave
Orange Park, FL 32065-6236

Phone

(904) 276-6644

Fax

(904) 276-6644

NPI assigned

Sep 20, 2013

Organization subpart

No

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

Authorized official

Name

Marie Jenkins

Title

Owner/Administrator

Phone

(904) 673-1419

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379635200000",
    "number": "1538595657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2485 RIDGECREST AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320656236",
            "telephone_number": "904-276-6644",
            "fax_number": "904-276-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2485 RIDGECREST AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320656236",
            "telephone_number": "904-276-6644",
            "fax_number": "904-276-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE PARK ASSISTED LIVING FACILITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-20",
        "last_updated": "2013-09-20",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "904-673-1419"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Orange Park, FL
• Providers in Orange Park, 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 Sep 20, 2013; 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.