BREAKWATER ADULT FAMILY CARE HOME LLC – NPI #1356407704
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

Health Care Provider Taxonomy Code for Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

BREAKWATER ADULT FAMILY CARE HOME LLC is a community based residential treatment facility located in DUNNELLON, FL. NPPES has assigned the NPI number 1356407704 to BREAKWATER ADULT FAMILY CARE HOME LLC on December 29, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. 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 BREAKWATER ADULT FAMILY CARE HOME LLC below.

NPI Profile for
BREAKWATER ADULT FAMILY CARE HOME LLC

NPI Number
1356407704
Enumeration Date

(more than 19 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
BREAKWATER ADULT FAMILY CARE HOME LLC
Primary location
22699 SW BREAKWATER BLVD
DUNNELLON, FL 34431-4039
Phone: (352) 401-7699 Fax: (352) 401-7698
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
VINCE JACOBS
OWNER
Phone: (352) 598-0288
Updated
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
320900000X
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)		 FL 6905655

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.