Lliingleside Retirement Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL5576 Issued in FL

Legal business name

LLIINGLESIDE RETIREMENT HOME

Practice address

1433 Ingleside Ave
Jacksonville, FL 32205-7712

Phone

(904) 389-6677

Fax

(904) 389-7011

NPI assigned

Dec 6, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Wajad Alli

Title

President

Phone

(904) 389-6677

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291593600000",
    "number": "1740583293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1433 INGLESIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322057712",
            "telephone_number": "904-389-6677",
            "fax_number": "904-389-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1433 INGLESIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322057712",
            "telephone_number": "904-389-6677",
            "fax_number": "904-389-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LLIINGLESIDE RETIREMENT HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-06",
        "last_updated": "2010-12-06",
        "status": "A",
        "authorized_official_last_name": "ALLI",
        "authorized_official_first_name": "WAJAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-389-6677",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL5576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001119000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tawana Lizzmore
• Juliana Andrea Llano, MD
• Stefan Llauro Rodriguez
• Marjana Llazar, FNP-C
• Llevate Health Homecare LLC
• Allison Lloyd, PHARMD
• Colleen Lloyd, LCSW
• Jessica Leigh Lloyd, APRN
• Shana D Lloyd
• Stephanie Lloyd

• 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 Dec 6, 2010; 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.