Coffee & Grace LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

COFFEE & GRACE LLC

Practice address

1821 N Pearl St Ste a
Jacksonville, FL 32206-3663

Phone

(904) 474-2192

Fax

(904) 212-0128

NPI assigned

Oct 1, 2020

Last updated

Oct 31, 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

Mrs. Alyssa Jacobs

Title

Chief Executive Officer

Phone

(904) 474-2192

Specialties & licenses 7

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Latrena M Thomas

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Jacksonville, FL
  • NPI 1760971923
  NPD

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

{
    "created_epoch": "1601510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604102400000",
    "number": "1750988895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 77581",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322267581",
            "telephone_number": "904-474-2192",
            "fax_number": "904-212-0128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 N PEARL ST STE A",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322063663",
            "telephone_number": "904-474-2192",
            "fax_number": "904-212-0128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COFFEE & GRACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-01",
        "last_updated": "2020-10-31",
        "certification_date": "2020-10-31",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "ALYSSA",
        "authorized_official_title_or_position": "CHIEF  EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "904-474-2192",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer L Cody
• Sandra Faye Cody, LMT
• Jessica Coe, RMHCI
• Haley Coen, DPT
• Murad Ishmael Cofer, PHARM.D
• Angel Coffey, APRN
• Julie G. Coffey, LCSW, SW
• Olivetta Taffney Coffey
• Shannon Dawn Coffey, LMHC
• Stephanie Marie Coffey, RN

• Home Health Agency in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.