J & S Adult Livivng Facility

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

AL11006 Issued in FL

Legal business name

J & S ADULT LIVIVNG FACILITY

Practice address

1343 Johns St
Jennings, FL 32053-3097

Phone

(386) 938-1336

Fax

(386) 938-2751

NPI assigned

Dec 10, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Sabrina Denise Marshall

Title

Administrator

Phone

(386) 938-1336

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1291939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291939200000",
    "number": "1902109010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1343 JOHNS ST.",
            "city": "JENNING",
            "state": "FL",
            "postal_code": "32053",
            "telephone_number": "386-938-1336",
            "fax_number": "386-938-2751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1343 JOHNS ST",
            "city": "JENNINGS",
            "state": "FL",
            "postal_code": "320533097",
            "telephone_number": "386-938-1336",
            "fax_number": "386-938-2751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J & S ADULT LIVIVNG FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-10",
        "last_updated": "2010-12-10",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "SABRINA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "386-938-1336",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AL11006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1429337",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Jennings, FL
• Assisted Living Facility (Mental Illness) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2010; 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.