NPIMap

Organization Active NPI

Power House Miracle Center

Doing business as The Kings House

  • Assisted Living Facility
  • Jacksonville, FL
National Provider Identifier
1619394434
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL11620 Issued in FL
Legal business name
POWER HOUSE MIRACLE CENTER
Doing business as
The Kings House
Practice address
10965 River Falls Dr
Jacksonville, FL 32219-5138
Phone
(904) 894-6828
NPI assigned
Mar 19, 2014
Last updated
Mar 19, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Authorized official

Name
Ms. Melissa A Wade
Title
Administrator
Phone
(904) 894-6828

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL11620 FL Primary

Addresses

Primary practice location

10965 River Falls Dr
Jacksonville, FL 32219-5138

Mailing address

10965 River Falls Dr
Jacksonville, FL 32219-5138
Phone (904) 894-6828

Other names 1

  • The Kings House Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Power House Miracle Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1395187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395187200000",
    "number": "1619394434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10965 RIVER FALLS DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322195138",
            "telephone_number": "904-894-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10965 RIVER FALLS DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322195138",
            "telephone_number": "904-894-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWER HOUSE MIRACLE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-19",
        "last_updated": "2014-03-19",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-894-6828",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL11620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Kings House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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.