IM SULZBACHER CENTER FOR THE HOMELESS, INC (NPI# 1396369187) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396369187 |
| Entity Type | Organization |
| Organization Name | IM SULZBACHER CENTER FOR THE HOMELESS, INC |
| Practice Address |
5455 Springfield Blvd Jacksonville FL 32208-5166 |
| Mailing Address |
611 E Adams St Jacksonville FL 32202-2847 |
| Practice Telephone | 9043944958 |
| Mailing Telephone | 9043945481 |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2020-06-08 |
| Authorized Official Name | CINDY FUNKHOUSER (CEO) |
| Authorized Official Telephone | 9043944958 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| SULZBACHER VILLAGE PEDIATRIC HEALTH | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710051354 | Im Sulzbacher Center for The Homeless, Inc | Clinic/Center | 611 E Adams St, Jacksonville, FL 32202-2847 | 2006-11-17 |
| Street Address |
5455 SPRINGFIELD BLVD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32208-5166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245845379 | Lameka Williams | Adult Companion | 6854 Cartier Cir, Jacksonville, FL 32208 | 2020-09-15 |
| 1386173722 | Danielle Mathews | Home Health | 6824 Barberie St., Jacksonville, FL 32208 | 2017-06-08 |
| 1063957520 | Crystal Tramaine Simmons | Licensed Practical Nurse | 3190 Sedona Trl, Jacksonville, FL 32208 | 2016-12-19 |
| 1508316084 | Melissa Angel | Emergency Medical Technician, Basic | 3701 Winton Drive, Jacksonville, FL 32208 | 2016-10-10 |
| 1093176828 | Stephanie Fears | Chore Provider | 5910 Droad St, Jacksonville, FL 32208 | 2016-03-07 |
| 1841676558 | Elizabeth Ann Miller | Social Worker | 1255 Lila Ave, Jacksonville, FL 32208 | 2015-08-04 |
| 1861877698 | Sara Castro | Counselor | 1110 Edgewood Ave West, Jacksonville, FL 32208 | 2015-07-22 |
| 1215352703 | Luther Quarles Iv | Family Medicine | 1760 Edgewood Ave W Ste A&b, Jacksonville, FL 32208 | 2014-02-20 |
| 1356776348 | Top of The Line Mobile Service | Durable Medical Equipment & Medical Supplies | 2252 4th Avenue, Jacksonville, FL 32208 | 2013-09-09 |
| 1437419124 | Carmelita Patrice Rowell | Specialist | 2255 Soutel Dr, Jacksonville, FL 32208 | 2012-05-29 |
| Find all providers in zip 32208 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518469527 | Special Health Resources for Texas, Incorporated | Clinic/Center | 1011 College Street, Jacksonville, TX 75766-3307 | 2018-03-06 |
| 1982069795 | Agape Community Health Center, Inc. | Clinic/Center | 5316 N Pearl St, Jacksonville, FL 32208-5119 | 2015-12-21 |
| 1497010425 | Fl Department of Health | Clinic/Center | 1736 University Blvd S, Jacksonville, FL 32216-8929 | 2012-07-05 |
| 1578892485 | Grandmary's House | Clinic/Center | 4828 Evanston Rd, Jacksonville, FL 32208 | 2009-12-24 |
| 1326668351 | Agape Community Health Center, Inc | Clinic/Center | 6024 Merrill Rd, Jacksonville, FL 32277-3427 | 2020-04-20 |
| 1376178814 | Agape Community Health Center, Inc | Clinic/Center | 1680 Dunn Ave Ste 35, Jacksonville, FL 32218-4744 | 2020-03-05 |
| 1760963516 | Arcare | Clinic/Center | 1400 Braden St Ste 1, Jacksonville, AR 72076-3721 | 2018-08-28 |
| 1649628009 | Board of Trustees of Southern Illinois University | Clinic/Center | 345 W State St, Jacksonville, IL 62650-1879 | 2016-05-26 |
| 1578928826 | Agape Community Health Center, Inc. | Clinic/Center | 5460 Blanding Blvd, Jacksonville, FL 32244-1957 | 2015-12-30 |
| 1245695774 | Agape Community Health Center, Inc | Clinic/Center | 3900 University Blvd S Ste 2, Jacksonville, FL 32216-4331 | 2015-12-29 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32208 |
Please comment or provide details below to improve the information on IM SULZBACHER CENTER FOR THE HOMELESS, INC.
| 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.