The Arc of the St Johns

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

THE ARC OF THE ST JOHNS

Practice address

2101 Arc Drive
St. Augustine, FL 32084

Phone

(904) 824-7249

NPI assigned

Oct 29, 2024

Organization subpart

No

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

Authorized official

Name

Justin Breidenstein

Title

Cfo

Phone

(904) 824-7249

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

The Arc of the St Johns Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• The Arc of the St Johns, Inc.

  • Community/Behavioral Health Agency
  • St Augustine, FL
  • NPI 1568536274
  NPD tax ID
• The Arc of the St. Johns

  • Behavior Analyst
  • St Augustine, FL
  • NPI 1487070744
  NPD tax ID

Locations

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

{
    "created_epoch": "1730160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730160000000",
    "number": "1699597880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 ARC DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320840512",
            "telephone_number": "904-824-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 ARC DRIVE",
            "city": "ST. AUGUSTINE",
            "state": "FL",
            "postal_code": "32084",
            "telephone_number": "904-824-7249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ARC OF THE ST JOHNS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-29",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "BREIDENSTEIN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "904-824-7249"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123049600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tender Loving Care Health Care Services of Florida, L.L.C. (Amedisys Home Health)
• Tender Luvin Care III Corp
• Deborah Fisher Terry, DNP, ARNP, ANP-BC
• Kimberly Dawn Terry, PHARM D
• Alyssa A Thaxton, LCSW
• The Arc of the St Johns, Inc.
• The Arc of the St. Johns
• The Arc of the St. Johns, Inc.
• The Best Dentist in Saint Augustine PLLC
• The Brighter Side of Life LLC

• Adult Day Care Clinic/Center in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Adult Day Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.