3455 SAN PABLO RD S TENANT LLC – NPI #1205664349
Assisted Living Facility

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

3455 SAN PABLO RD S TENANT LLC is an assisted living facility located in JACKSONVILLE, FL. NPPES has assigned the NPI number 1205664349 to 3455 SAN PABLO RD S TENANT LLC on July 22, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 310400000X from the Health Care Provider Taxonomy code set, which is classified as Assisted Living Facility.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for 3455 SAN PABLO RD S TENANT LLC below.

NPI Profile for
3455 SAN PABLO RD S TENANT LLC

NPI Number
1205664349
Enumeration Date

(about 2 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
3455 SAN PABLO RD S TENANT LLC
Primary location
3455 SAN PABLO RD S
JACKSONVILLE, FL 32224-3803
Phone: (904) 821-8030 Fax:
Mailing address
8415 E 21ST ST N STE 100
WICHITA, KS 67206-2959
Phone: (316) 616-6288 Fax:
Organization Subpart
No
Authorized Official
SHARON MAKOWSKY
AUTHORIZED REPRESENTATIVE
Phone: (419) 247-2800
Updated
Certification Date
Jun 28, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
310400000X
- Assisted Living Facility (Primary)
311500000X
- Alzheimer Center (Dementia Center)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.