SAN JUAN RETIREMENT HOME (NPI# 1053656199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053656199 |
| Entity Type | Organization |
| Organization Name | SAN JUAN RETIREMENT HOME |
| Practice Address |
6561 San Juan Ave Jacksonville FL 32210-2857 |
| Practice Telephone | 9046959605 |
| Practice Fax Number | 9046931973 |
| Mailing Telephone | 9046959605 |
| Mailing Fax Number | 9046931973 |
| Enumeration Date | 2012-11-29 |
| Last Update Date | 2012-11-29 |
| Authorized Official Name | ELVIRA CHUA DEMDAM (ALF ADMINISTRATOR) |
| Authorized Official Telephone | 9046959605 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311500000X | Alzheimer Center (Dementia Center) | 9587 | FL | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891032868 | San Juan Retirement Home | Assisted Living Facility | 6561 San Juan Ave, Jacksonville, FL 32210-2857 | 2013-01-11 |
| Street Address |
6561 SAN JUAN AVE |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32210-2857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447374111 | Vicki Lorayne Sellner | Occupational Therapist | 6561 San Juan Ave, Jacksonville, FL 32210-2857 | 2007-03-19 |
| 1831704022 | Noble House Senior Living, LLC | Assisted Living Facility | 6561 San Juan Ave, Jacksonville, FL 32210-2857 | 2020-09-14 |
| 1114326410 | Noble House Retirement of Jacksonville | Assisted Living Facility | 6561 San Juan Ave, Jacksonville, FL 32210-2857 | 2014-08-22 |
| 1891032868 | San Juan Retirement Home | Assisted Living Facility | 6561 San Juan Ave, Jacksonville, FL 32210-2857 | 2013-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326604729 | Finding Balance Counseling, LLC | Counselor | 4705 Palmer Ave, Jacksonville, FL 32210 | 2019-05-13 |
| 1609349620 | Jennifer Lash | Counselor | 4705 Palmer Avenue, Jacksonville, FL 32210 | 2019-01-03 |
| 1588147854 | Alan Craig Ashkinazy | Chiropractor | 5233 Ricker Rd Ste 102, Jacksonville, FL 32210 | 2018-09-12 |
| 1841781671 | Amanda Rodriguez-medina | Chiropractor | 6640 103rd St, Jacksonville, FL 32210 | 2018-05-29 |
| 1518457357 | Vicki Teal | Nurse Practitioner | 6488 103rd Street, Suite A, Jacksonville, FL 32210 | 2018-05-17 |
| 1811412539 | River City Companionship LLC | Clinic/Center | 7857 Delaroche Drive, Jacksonville, FL 32210 | 2017-08-03 |
| 1306366216 | Always Straight From The Heart | Homemaker | 6511 Betsy Court, Jacksonville, FL 32210 | 2017-06-21 |
| 1720538556 | Total Renal Care Inc | Clinic/Center | 5276 Blanding Blvd Ste 26, Jacksonville, FL 32210 | 2016-10-05 |
| 1700333978 | Recovery Counseling and More Inc | Clinic/Center | 4570 Saint Johns Ave, Ste B, Jacksonville, FL 32210 | 2016-09-06 |
| 1831645662 | Drucilla Young | Nurse's Aide | 1700 Blanding Blvd. 68n, Jacksonville, FL 32210 | 2016-08-31 |
| Find all providers in zip 32210 | ||||
| Taxonomy Code | 311500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Alzheimer Center (Dementia Center) |
| A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer’s Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982172995 | Pacifica Augustine Road LLC | Alzheimer Center (Dementia Center) | 10660 Old Augustine Road, Jacksonville, FL 32257 | 2018-11-07 |
| 1780160192 | Ganesh Healthcare of Jax LLC | Alzheimer Center (Dementia Center) | 644 Cesery Blvd Ste 150, Jacksonville, FL 32211 | 2018-07-18 |
| 1811208804 | Peaches-na-basket Adult Day Care Center, Inc. | Alzheimer Center (Dementia Center) | 2040 Soutel Dr, Jacksonville, FL 32208-2280 | 2010-06-24 |
| 1184832107 | Esc New Port Richey, LLCemeritus Properties Ngh LLC | Alzheimer Center (Dementia Center) | 6895 Belfort Oaks Pl, Jacksonville, FL 32216-6242 | 2007-05-21 |
| 1912920174 | Liberty Healthcare Group, LLC | Alzheimer Center (Dementia Center) | 3045 Henderson Dr, Jacksonville, NC 28546-5247 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114527744 | Somh Boca Raton Operating, LLC | Alzheimer Center (Dementia Center) | 21865 Ponderosa Dr, Boca Raton, FL 33428-6215 | 2020-11-01 |
| 1417556978 | Mh Gentry Park Al Operating, LLC | Alzheimer Center (Dementia Center) | 3201 Center Pointe Dr, Orlando, FL 32825-6323 | 2020-10-25 |
| 1144876327 | Immaculate Adult Day Care LLC | Alzheimer Center (Dementia Center) | 234 Willard St Ste A, Cocoa, FL 32922-7984 | 2019-08-14 |
| 1689152910 | American Eagle Leesburg Mc LLC | Alzheimer Center (Dementia Center) | 710 S Lake St, Leesburg, FL 34748-7327 | 2018-07-30 |
| 1518445857 | American Eagle Venice Island LLC | Alzheimer Center (Dementia Center) | 1200 Avenida Del Circo, Venice, FL 34285 | 2018-07-30 |
| 1861917171 | Memory Lane Cottage At Oviedo, LLC | Alzheimer Center (Dementia Center) | 450 Oviedo Blvd, Oviedo, FL 32765-3508 | 2017-08-08 |
| 1891219119 | Waveney Gittens-williams | Alzheimer Center (Dementia Center) | 3706 W. Idle Wild Cir #203, Tampa, FL 33614 | 2017-07-28 |
| 1831640697 | Senior Living Iv Sun City, LLC | Alzheimer Center (Dementia Center) | 1320 33rd St Se, Ruskin, FL 33573-4904 | 2016-10-17 |
| 1881144699 | Mease Manor, Inc. | Alzheimer Center (Dementia Center) | 603 Virginia St, Dunedin, FL 34698-6613 | 2016-10-05 |
| 1396196861 | Excel Hospitality Group, LLC | Alzheimer Center (Dementia Center) | 15000 N Highway 441, Eustis, FL 32726-6589 | 2016-06-27 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 32210 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.