Peaches-NA-Basket Adult Day Care Center, Inc.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

PEACHES-NA-BASKET ADULT DAY CARE CENTER, INC.

Practice address

2040 Soutel Dr
Jacksonville, FL 32208-2280

Phone

(904) 766-4993

Fax

(904) 713-9966

NPI assigned

Jun 24, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Bertha Dolores Flemming, MS, NHA

Title

Executive Director

Phone

(904) 766-4993

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663718400000",
    "number": "1811208804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 SOUTEL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322082280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 SOUTEL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322082280",
            "telephone_number": "904-766-4993",
            "fax_number": "904-713-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHES-NA-BASKET ADULT DAY CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-24",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A",
        "authorized_official_last_name": "FLEMMING",
        "authorized_official_first_name": "BERTHA",
        "authorized_official_middle_name": "DOLORES",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "904-766-4993",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, NHA"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "672949500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Day Care Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Adult Day Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.