River Garden Hebrew Home for the Aged

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1476096 Issued in FL

Legal business name

RIVER GARDEN HEBREW HOME FOR THE AGED

Practice address

11401 Old Saint Augustine Rd
Jacksonville, FL 32258

Phone

(904) 260-1818

Fax

(904) 260-9733

NPI assigned

Jun 30, 2005

Last updated

May 13, 2026By 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

Mauri Mizrahi, LNHA

Title

Ceo

Phone

(904) 260-1818

Specialties & licenses 8

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669479192. Details of each certification follow.

• CCN 105016 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 105016

Legal name

RIVER GARDEN HEBREW HOME FOR THE AGED

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 1, 1967

Last certification

Oct 31, 2024

Beds

180

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Mar 7, 1946 in FL

Enrollment address

11401 Old Saint Augustine Rd
Jacksonville, FL 32258-1402

Nursing home name

RIVER GARDEN HEBREW HOME FOR THE AGED

Listed as

River Garden Hebrew Home for the AgedCCN 105016 · All quality measures

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

5 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Jan 1, 1967

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

180163.4 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Tax ID family

River Garden Hebrew2 organizations share this tax ID, including this one

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• River Garden Hebrew Home for the Aged

  • Home Health Agency
  • Jacksonville, FL
  • NPI 1457609984

  Member Of

  NPD member

Locations

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• River Garden Hebrew Home for the Aged

  • Home Health Agency
  • Jacksonville, FL
  • NPI 1457609984
  NPPES parent name

Affiliated clinicians 7

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Rebecca H Andrew, MD

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1760596647

  Nursing home

  Care Compare affiliation
• Kathleen A Gannon, APRN

  • Nurse Practitioner
  • Jacksonville, FL
  • NPI 1952818809

  Nursing home

  Care Compare affiliation
• Anjali Gupta, MD

  • Internal Medicine Physician
  • Ponte Vedra, FL
  • NPI 1922265123

  Nursing home

  Care Compare affiliation
• Samantha E Kraly, MD

  • Internal Medicine Physician
  • St Augustine, FL
  • NPI 1477507473

  Nursing home

  Care Compare affiliation
• Jeffery T Lumley, D.O.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1831231299

  Nursing home

  Care Compare affiliation
• Francisco Javier Martinez-Wittinghan, MD

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1568696011

  Nursing home

  Care Compare affiliation
• Bud L Wolfson, MD

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1699743807

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1669479192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11401 OLD SAINT AUGUSTINE RD # 106",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322584500",
            "telephone_number": "904-260-1818",
            "fax_number": "904-260-9733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11401 OLD SAINT AUGUSTINE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32258",
            "telephone_number": "904-260-1818",
            "fax_number": "904-260-9733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER GARDEN HEBREW HOME FOR THE AGED",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "MIZRAHI",
        "authorized_official_first_name": "MAURI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-260-1818",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "HHA299991334",
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "FL",
            "license": "SNF1476096",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1476096",
            "primary": true
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "FL",
            "license": "SNF1476096",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "FL",
            "license": "SNF1476096",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "FL",
            "license": "PH2050",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020085900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• River City Pediatric Dentistry, P.a.
• River City Physical Therapy
• River City Professional Services, Inc. (River City Home Health)
• River City Vision Center PA
• River Garden Hebrew Home for the Aged
• River Hills Chiropractic Clinic Inc
• River Oaks Dental
• River Region Human Services
• River Region Human Services Inc (River Region Primary Care)
• River Region Human Services Inc

• Skilled Nursing Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.