NPIMap

Organization Active NPI

Salem Villages MRDD, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Jacksonville, FL
National Provider Identifier
1861560385
Registry record updated Jan 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
SALEM VILLAGES MRDD, INC.
Practice address
4748 Tunis St
Jacksonville, FL 32205-7379
Phone
(352) 372-0130
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2011

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

Authorized official

Name
Ms. Deena Ombres
Title
Privacy Officer
Phone
(502) 394-2387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

4748 Tunis St
Jacksonville, FL 32205-7379

Mailing address

10140 Linn Station Rd
Louisville, KY 40223-3813
Phone (800) 866-0860

Other identifiers 1

IdentifierTypeStateIssuer
028563300MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Res-Care Health Services148 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294012800000",
    "number": "1861560385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10140 LINN STATION RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402233813",
            "telephone_number": "800-866-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4748 TUNIS ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322057379",
            "telephone_number": "352-372-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALEM VILLAGES MRDD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2011-01-03",
        "status": "A",
        "authorized_official_last_name": "OMBRES",
        "authorized_official_first_name": "DEENA",
        "authorized_official_title_or_position": "PRIVACY OFFICER",
        "authorized_official_telephone_number": "502-394-2387",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028563300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 3, 2011; 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.