Interim Healthcare of Jacksonville, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HHA205710961 Issued in FL

Legal business name

INTERIM HEALTHCARE OF JACKSONVILLE, INC.

Practice address

2233 Park Ave
Suite 304
Orange Park, FL 32073-5570

Phone

(904) 527-2030

Fax

(904) 621-0968

NPI assigned

Nov 29, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Glenn Robin Reeves

Title

President

Phone

(904) 448-1133

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348012800000",
    "number": "1780667220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7999 PHILIPS HWY",
            "address_2": "SUITE 304",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322564443",
            "telephone_number": "904-448-1133",
            "fax_number": "904-448-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 PARK AVE",
            "address_2": "SUITE 304",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735570",
            "telephone_number": "904-527-2030",
            "fax_number": "904-621-0968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERIM HEALTHCARE OF JACKSONVILLE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-29",
        "last_updated": "2012-09-19",
        "status": "A",
        "authorized_official_last_name": "REEVES",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "ROBIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-448-1133",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "HHA205710961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Orange Park, FL
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• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; 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.