NPIMap

Organization Active NPI

Communtiy Rehabilitation Center, Inc.

Doing business as None

  • Case Management Agency
  • Jacksonville, FL
National Provider Identifier
1952304511
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
COMMUNTIY REHABILITATION CENTER, INC.
Doing business as
None
Practice address
623 Beechwood St
Jacksonville, FL 32206-6236
Phone
(904) 358-1211
Fax
(904) 358-1551
NPI assigned
May 27, 2005
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. Reginald L Gaffney Sr., EXECUTIVE DIRECTOR
Title
Executive Director
Phone
(904) 358-1211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X FL Primary

Addresses

Primary practice location

623 Beechwood St
Jacksonville, FL 32206-6236

Mailing address

623 Beechwood St
Jacksonville, FL 32206-6236
Phone (904) 358-1211

Other names 1

  • None Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Rehabilitation Center Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952304511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 BEECHWOOD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322066236",
            "telephone_number": "904-358-1211",
            "fax_number": "904-358-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 BEECHWOOD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322066236",
            "telephone_number": "904-358-1211",
            "fax_number": "904-358-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNTIY REHABILITATION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GAFFNEY",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "904-358-1211",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "EXECUTIVE DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "None",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 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.