NPIMap

Organization Active NPI

Northeast Florida Residential Care Facility Inc

  • In Home Supportive Care Agency
  • Orange Park, FL
National Provider Identifier
1982460747
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
NORTHEAST FLORIDA RESIDENTIAL CARE FACILITY INC
Practice address
4232 Arbor Mill Cir
Orange Park, FL 32065-3204
Phone
(904) 532-5186
NPI assigned
Feb 27, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Authorized official

Name
Leaundria Denise Shaheed
Title
Owner
Phone
(904) 532-5186

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Meals Provider 174200000X
Lodging Provider 177F00000X
Community Based Hospice Care Agency 251G00000X
In Home Supportive Care Agency 253Z00000X Primary
Respite Care 385H00000X
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X

Addresses

Primary practice location

4232 Arbor Mill Cir
Orange Park, FL 32065-3204

Mailing address

4232 Arbor Mill Cir
Orange Park, FL 32065-3204
Phone (904) 532-5186

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708992000000",
    "number": "1982460747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4232 ARBOR MILL CIR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320653204",
            "telephone_number": "904-532-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4232 ARBOR MILL CIR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320653204",
            "telephone_number": "904-532-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST FLORIDA RESIDENTIAL CARE FACILITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A",
        "authorized_official_last_name": "SHAHEED",
        "authorized_official_first_name": "LEAUNDRIA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-532-5186"
    },
    "taxonomies": [
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.