St. Augustine Group Homes, Inc

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

ST. AUGUSTINE GROUP HOMES, INC

Practice address

1735 State Road 16
St Augustine, FL 32084-0807

Phone

(904) 824-4391

Fax

(904) 826-3835

NPI assigned

Feb 5, 2007

Last updated

Aug 22, 2020By 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

Mr. Shane Moran

Title

Administrator

Phone

(904) 824-4391

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629117163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 STATE ROAD 16",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320840807",
            "telephone_number": "904-824-4391",
            "fax_number": "904-826-3835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 STATE ROAD 16",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320840807",
            "telephone_number": "904-824-4391",
            "fax_number": "904-826-3835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. AUGUSTINE GROUP HOMES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-824-4391",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Augustine Direct Primary Care, LLC
• St. Augustine Ear, Nose & Throat, L.L.C.
• St. Augustine Foot & Ankle, Inc (St Augustine Rheumatology Center)
• St. Augustine Foot & Ankle, Inc
• St. Augustine Foot & Ankle, Inc.
• St. Augustine Pediatric Associates, PA
• St. Augustine Pediatric Associates, PA
• St. Augustine Surgery Center
• St. Augustine Therapy LLC
• St. John's Pediatrics, P.a.

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.