Organization Active NPI

Daisy Adams Center, Inc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • St Augustine, FL
National Provider Identifier
1841339116
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
DAISY ADAMS CENTER, INC
Practice address
1735 State Road 16
St Augustine, FL 32084-0807
Phone
(904) 824-4391
Fax
(904) 826-3835
NPI assigned
Feb 5, 2007
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. Shane Moran
Title
Administrator
Phone
(904) 824-4391

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X FL Primary

Addresses

Primary practice location

1735 State Road 16
St Augustine, FL 32084-0807

Mailing address

1735 State Road 16
St Augustine, FL 32084-0807
Phone (904) 824-4391

National Provider Directory

National Provider Directory
Tax ID family
Daisy Adams Center Inc2 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.

Locations

1735 State Road 16
Saint Augustine, FL 32084
Phone (904) 824-4391

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841339116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 STATE ROAD 16",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320840807",
            "telephone_number": "904-824-4391",
            "fax_number": "904-826-3835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 STATE ROAD 16",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320840807",
            "telephone_number": "904-824-4391",
            "fax_number": "904-826-3835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAISY ADAMS CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-824-4391",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, 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.