Pacifica Augustine Road LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PACIFICA AUGUSTINE ROAD LLC

Practice address

10660 Old Augustine Road
Jacksonville, FL 32257

Phone

(914) 262-4600

Fax

(904) 262-1939

NPI assigned

Nov 7, 2018

Organization subpart

No

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

Authorized official

Name

Deepak Israni

Title

Managing Partner

Phone

(619) 296-9000

Specialties & licenses 2

Addresses

Other names 1

• Wyndham Lakes A Pacifica Senior Living Community Doing business as

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541548800000",
    "number": "1982172995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 HANCOCK STREET",
            "address_2": "SUITE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92110",
            "telephone_number": "619-296-9000",
            "fax_number": "619-296-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10660 OLD AUGUSTINE ROAD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32257",
            "telephone_number": "914-262-4600",
            "fax_number": "904-262-1939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFICA AUGUSTINE ROAD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-07",
        "last_updated": "2018-11-07",
        "status": "A",
        "authorized_official_last_name": "ISRANI",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "619-296-9000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wyndham Lakes A Pacifica Senior Living Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan Pace
• Olicia C Pace
• Samuel David Pace, MSCD, LMT
• Brittany Anne Pacella, MA
• Frank Oliver Pacetti, PA-C
• Pacifica Care PLLC
• Breah Lynn Paciotti, PA-C
• Norman W. Pack, M.D.
• David Paden
• Corinne Ruth Padgett, PA-C

• 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 Nov 7, 2018; 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.