JFK Group Homes LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

090752 Issued in FL

Legal business name

JFK GROUP HOMES LLC

Practice address

1643 Farmington Cir
Wellington, FL 33414-8923

Phone

(561) 795-9575

Fax

(561) 795-6906

NPI assigned

Sep 29, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Stuart R Russell

Title

Member

Phone

(561) 863-7055

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1932291556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 45TH ST STE A5",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072161",
            "telephone_number": "561-863-7055",
            "fax_number": "561-863-6577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1643 FARMINGTON CIR",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334148923",
            "telephone_number": "561-795-9575",
            "fax_number": "561-795-6906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JFK GROUP HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "561-863-7055",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": "090752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "682871096",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Wellington, FL
• Providers in Wellington, FL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.