NPIMap

Organization Active NPI

Communityrehabilitation Center Inc

  • Developmentally Disabled Services Day Training Agency
  • Jacksonville, FL
National Provider Identifier
1790854669
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
COMMUNITYREHABILITATION CENTER INC
Practice address
623 Beechwood St
Jacksonville, FL 32206-6236
Phone
(904) 358-1211
Fax
(904) 349-8555
NPI assigned
Nov 7, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Reginald L Gaffney
Title
Executive Director
Phone
(904) 358-1211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

623 Beechwood St
Jacksonville, FL 32206-6236

Mailing address

623 Beechwood St
Jacksonville, FL 32206-6236
Phone (904) 358-1211

Other names 1

  • communityRehaabilitation Center Inc Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Community Rehabilitation Center Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790854669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 BEECHWOOD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322066236",
            "telephone_number": "904-358-1211",
            "fax_number": "904-349-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 BEECHWOOD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322066236",
            "telephone_number": "904-358-1211",
            "fax_number": "904-349-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITYREHABILITATION CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GAFFNEY",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "904-358-1211",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "communityRehaabilitation Center Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.