Hagan Assisted Living Facility

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10746 Issued in FL

Legal business name

HAGAN ASSISTED LIVING FACILITY

Practice address

3104 W 12TH St
Jacksonville, FL 32254-1808

Phone

(904) 382-3655

NPI assigned

Dec 8, 2008

Organization subpart

No

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

Authorized official

Name

Sharon McIntyre

Title

President

Phone

(904) 382-3655

Specialties & licenses 2

Addresses

Other identifiers 1

Tax ID family

Hagan Assisted Living Facility2 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.

• Just Like Home

  • Assisted Living Facility
  • Jacksonville, FL
  • NPI 1730632233
  NPD tax ID

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

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228694400000",
    "number": "1801031638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 W 12TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322541808",
            "telephone_number": "904-382-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 W 12TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322541808",
            "telephone_number": "904-382-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAGAN ASSISTED LIVING FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-08",
        "last_updated": "2008-12-08",
        "status": "A",
        "authorized_official_last_name": "MCINTYRE",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-382-3655"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10746",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "FL",
            "license": "AL10746",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amra Hadzic, M.D.
• Virginia Ann Haesler
• Jeffrey Hafendorfer, CRNA
• Brenda Eileen Haga, MS
• Claire Haga, MD
• Hagan Homemaker Companion Service
• Chandala Monique Hagans, APRN
• George T Hage-Nassar, MD
• Virginia Lee Hagen, LMHC
• Jackie Floyd Hagenbaumer

• 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 8, 2008; 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.