Generation Legacy Consultant LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GENERATION LEGACY CONSULTANT LLC

Practice address

3075 Lowell Ave
Jacksonville, FL 32254-3125

Phone

(904) 248-9363

NPI assigned

Mar 27, 2023

Last updated

Mar 27, 2023By 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

Nicole Cleveland

Title

Owner

Phone

(904) 248-9363

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1609579853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1878 GREEN ISLAND CIR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320652602",
            "telephone_number": "904-248-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 LOWELL AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322543125",
            "telephone_number": "904-248-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERATION LEGACY CONSULTANT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-25",
        "status": "A",
        "authorized_official_last_name": "CLEVELAND",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-248-9363"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.