MARJORIE G. CUPP (NPI# 1649426065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649426065 |
| Entity Type | Organization |
| Organization Name | MARJORIE G. CUPP |
| Practice Address |
1545 Parkwood St Jacksonville FL 32207-5476 |
| Practice Telephone | 9048589740 |
| Practice Fax Number | 9047332681 |
| Mailing Telephone | 9048589740 |
| Mailing Fax Number | 9047332681 |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2008-08-18 |
| Authorized Official Name | MS. MARJORIE G. CUPP (PROVIDER) |
| Authorized Official Telephone | 9048589740 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | ========= | FL | Residential Treatment Facilities |
| N | 320700000X | Residential Treatment Facility, Physical Disabilities | ========= | FL | Residential Treatment Facilities |
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | ========= | FL | Residential Treatment Facilities |
| Street Address |
1545 PARKWOOD ST |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-5476 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811145006 | Michelle Johnson | Residential Treatment Facility, Physical Disabilities | 1545 Parkwood St, Jacksonville, FL 32207-5476 | 2008-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124628565 | Rachelle Homehealth Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8539 Gate Pkwy W Unit 9134, Jacksonville, FL 32216-1037 | 2020-10-26 |
| 1306459359 | Joy-little Enterprise LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9148 Ridge Blvd, Jacksonville, FL 32208-1265 | 2020-08-28 |
| 1346873882 | Cojo Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3825 Leonard Cir W, Jacksonville, FL 32209-3754 | 2020-02-12 |
| 1306497672 | Tamara Belcher-bostick | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2020 Almira St, Jacksonville, FL 32211-4604 | 2019-09-26 |
| 1235786856 | Mary Imhansiemhonehi | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4568 Antler Hill Dr E, Jacksonville, FL 32224-8704 | 2019-08-19 |
| 1942866611 | Linda R Siplin-kerrin | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11855 Alexandra Dr, Jacksonville, FL 32218-8878 | 2019-05-17 |
| 1417414053 | Danx Group LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6859 Lenox Ave # 32, Jacksonville, FL 32205-6149 | 2019-03-01 |
| 1558834879 | Annquenette C Daniels | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6859 Lenox Ave Ste 32, Jacksonville, FL 32205-6149 | 2019-01-09 |
| 1730650573 | Turnaround Retreat | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1159 E 13th St, Jacksonville, FL 32206-3105 | 2018-12-05 |
| 1962982090 | Joyful Care, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6500 Lake Gray Blvd Apt 322, Jacksonville, FL 32244-7553 | 2018-08-17 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
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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.