Harborchase of Jacksonville, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL9726 Issued in FL

Legal business name

HARBORCHASE OF JACKSONVILLE, INC.

Doing business as

HarborChase of Jacksonville

Practice address

3455 San Pablo Rd S
Jacksonville, FL 32224-3803

Phone

(904) 821-8030

Fax

(904) 821-8002

NPI assigned

Jan 3, 2014

Organization subpart

No

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

Authorized official

Name

Thomas Mitchell

Title

Treasurer

Phone

(772) 492-5002

Specialties & licenses 1

Addresses

Other names 1

• HarborChase of Jacksonville Doing business as

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

{
    "created_epoch": "1388707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388707200000",
    "number": "1619398971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 HIGHWAY A1A",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329632310",
            "telephone_number": "772-492-5002",
            "fax_number": "772-492-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322243803",
            "telephone_number": "904-821-8030",
            "fax_number": "904-821-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBORCHASE OF JACKSONVILLE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-03",
        "last_updated": "2014-01-03",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "772-492-5002"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL9726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HarborChase of Jacksonville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Jacksonville, FL
• Providers in Jacksonville, 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 Jan 3, 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.