LAKENYA JACOBS (NPI# 1487122248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487122248 |
| Entity Type | Individual |
| Full Name | LAKENYA JACOBS |
| Practice Address |
937 Commerce Rd Se Palm Bay FL 32909-4732 |
| Practice Telephone | 3216260930 |
| Mailing Telephone | 3216260930 |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2018-11-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 100108400 | 05 |
| Street Address |
937 COMMERCE RD SE |
| City | PALM BAY |
| State | FL |
| Zip Code | 32909-4732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790383164 | Chestnut Bay Assisted Living Facilities | Assisted Living Facility | 937 Commerce Rd Se, Palm Bay, FL 32909-4732 | 2020-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205447349 | Sarah Nicosia | Registered Nurse | 2752 Palisades Dr, Palm Bay, FL 32909 | 2020-08-12 |
| 1447881297 | Shangri-la of Palm Bay Alf, LLC | Assisted Living Facility | 3604 Jupiter Blvd. Se, Palm Bay, FL 32909 | 2020-01-30 |
| 1972094357 | Mindful Counseling and Wellness LLC | Social Worker | 221 Devlin Ct Se, Palm Bay, FL 32909 | 2018-05-22 |
| 1306348859 | Mallory Kathleen Herndon | Behavior Technician | 458 Barcelona Rd, Palm Bay, FL 32909 | 2018-03-01 |
| 1548786627 | Chotsani Merrill | Home Health Aide | 781 Davenport St Se, Palm Bay, FL 32909 | 2017-08-21 |
| 1639629538 | Maggie Cameron | Clinic/Center | 2511 Quentin Ave Ne, Palm Bay, FL 32909 | 2016-10-04 |
| 1194195016 | Dawn Goodwin | Pharmacist | 3450 Bayside Lakes Shopping Center, Palm Bay, FL 32909 | 2015-10-05 |
| 1124407796 | Jorge Ortiz | Physical Therapist | 470 Malabar Rd Se, Ste 102, Palm Bay, FL 32909 | 2015-05-28 |
| 1932506227 | Annalisa Tietjen I | Dental Hygienist | 714 Ave C, Fort Pierce, FL 32909 | 2014-12-02 |
| 1194147611 | Carl Glenmore Morrison Sr. | General Practice | 2125 Windbrook Drive, Palm Bay, FL 32909 | 2014-01-17 |
| Find all providers in zip 32909 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487118584 | Marie Hamid | Custodial Care Facility | 136 Deauville Ave Ne, Palm Bay, FL 32907-3031 | 2019-01-23 |
| 1215426598 | Cheryl C Liburd | Custodial Care Facility | 898 Fairhaven St Ne, Palm Bay, FL 32907-3270 | 2018-05-02 |
| 1396282489 | No Better Place | Custodial Care Facility | 840 Damask St Ne, Palm Bay, FL 32905-5711 | 2017-01-26 |
| 1366895195 | Lewis Adult Family Care Home | Custodial Care Facility | 149 Hagerstown St Sw, Palm Bay, FL 32908-7631 | 2016-07-17 |
| 1205243607 | Inez Gwendolyn Freeman, Robert Lee Freeman | Custodial Care Facility | 1771 Halfmoon St Nw, Palm Bay, FL 32907-9220 | 2014-07-17 |
| 1205242864 | Elizabeth Ann Marie Taylor | Custodial Care Facility | 1474 Meadowbrook Rd Ne, Palm Bay, FL 32905-5007 | 2014-07-03 |
| 1992116149 | Evena Jean Charles | Custodial Care Facility | 1551 Dozier Cir Se, Palm Bay, FL 32909-6535 | 2014-05-09 |
| 1073944906 | Kalaisha Brown | Custodial Care Facility | 861 Gena Rd Sw, Palm Bay, FL 32908-1739 | 2013-12-03 |
| 1528495868 | Joycie M Johnson | Custodial Care Facility | 2698 Hester Ave Se, Same, Palm Bay, FL 32909-7607 | 2013-10-01 |
| 1871836908 | Adult Family Home Care, Inc. | Custodial Care Facility | 2052 Syracuse Ct Ne, Palm Bay, FL 32905-3923 | 2013-03-27 |
| Find all providers in PALM BAY | ||||
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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.