Tambolina Services Community Resident Home, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

TAMBOLINA SERVICES COMMUNITY RESIDENT HOME, INC

Practice address

6285 Cranberry LN W
Jacksonville, FL 32244-2559

Phone

(904) 651-1310

Fax

(904) 240-0309

NPI assigned

Oct 15, 2020

Organization subpart

No

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

Authorized official

Name

Tamba Medza Momorie, EDD

Title

Associate Administrator

Phone

(904) 629-9922

Specialties & licenses 1

Addresses

Other names 1

• TAMBOLINA SERVICES COMMUNITY RESIDENT HOME Former legal business name

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1902404668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6285 CRANBERRY LN W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322442559",
            "telephone_number": "904-651-1310",
            "fax_number": "904-240-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6285 CRANBERRY LN W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322442559",
            "telephone_number": "904-651-1310",
            "fax_number": "904-240-0309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMBOLINA SERVICES COMMUNITY RESIDENT HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-14",
        "status": "A",
        "authorized_official_last_name": "MOMORIE",
        "authorized_official_first_name": "TAMBA",
        "authorized_official_middle_name": "MEDZA",
        "authorized_official_title_or_position": "ASSOCIATE ADMINISTRATOR",
        "authorized_official_telephone_number": "904-629-9922",
        "authorized_official_credential": "EDD"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TAMBOLINA SERVICES COMMUNITY RESIDENT HOME",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Robi E Tamargo, PSYD
• Christine Alexis Tamayo, MD
• Jesus Tamayo, COTA
• Tambolina Adult Day Care (Tambolina Day Center)
• Tambolina Adult Day Care Center (Tambolina Adult Day Care Center, Inc)
• Tambolina Services, Inc
• Lynne Tamplin, PT
• Allura Kaylen Tan
• Benjamin Tian-Hai Tan, DO
• Danica Tan

• 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 Oct 15, 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.