NPIMap

Organization Active NPI

Jra Adult Family Care Home

  • Adult Care Home Facility
  • Palm Coast, FL
National Provider Identifier
1740915024
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
JRA ADULT FAMILY CARE HOME
Doing business as
Jra Adult Family Care Home
Practice address
41 Woodlawn Dr
Palm Coast, FL 32164-7915
Phone
(386) 931-9871
NPI assigned
Jul 20, 2022
Last updated
Jul 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Joseph Alex Apollon
Title
Owner, Administrator
Phone
(386) 931-9871

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X NU Primary

Addresses

Primary practice location

41 Woodlawn Dr
Palm Coast, FL 32164-7915

Mailing address

41 Woodlawn Dr
Palm Coast, FL 32164-7915
Phone (386) 931-9871

Other names 1

  • JRA ADULT FAMILY CARE HOME Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Apollon Joseph a Carine T2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1740915024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 WOODLAWN DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321647915",
            "telephone_number": "386-931-9871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 WOODLAWN DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321647915",
            "telephone_number": "386-931-9871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JRA ADULT FAMILY CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-09",
        "status": "A",
        "authorized_official_last_name": "APOLLON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ALEX",
        "authorized_official_title_or_position": "OWNER, ADMINISTRATOR",
        "authorized_official_telephone_number": "386-931-9871"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JRA ADULT FAMILY CARE HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.