South Jacksonville FL Caregiving LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

SOUTH JACKSONVILLE FL CAREGIVING LLC

Doing business as

Cornerstone Caregiving

Practice address

1628 San Marco Blvd
Jacksonville, FL 32207-3000

Phone

(904) 830-6360

NPI assigned

Mar 3, 2021

Organization subpart

Yes

Parent organization

CORNERSTONE CAREGIVING LLCAs reported in NPPES

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

Authorized official

Name

Avery Lain

Title

VP Business Development

Phone

(817) 991-7836

Specialties & licenses 1

Addresses

Other names 1

• Cornerstone Caregiving Doing business as

Electronic endpoints 1

Part of

Cornerstone Caregiving LLC

Locations

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614729600000",
    "number": "1952996829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 S 28TH ST",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767107415",
            "telephone_number": "817-991-7836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 SAN MARCO BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073000",
            "telephone_number": "904-830-6360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JACKSONVILLE FL CAREGIVING LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORNERSTONE CAREGIVING LLC",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A",
        "authorized_official_last_name": "LAIN",
        "authorized_official_first_name": "AVERY",
        "authorized_official_title_or_position": "VP BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "817-991-7836"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "southjacksonvillefl@cornerstonecaregiving.com",
            "affiliation": "N",
            "endpointDescription": "Site Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1628 San Marco Blvd",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322073000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Cornerstone Caregiving",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• In Home Supportive Care Agency in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• In Home Supportive Care Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; 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.