JACKSONVILLE CARE CENTER, LLC (NPI# 1720512643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720512643 |
| Entity Type | Organization |
| Organization Name | JACKSONVILLE CARE CENTER, LLC |
| Practice Address |
1500 Graham Rd Jacksonville AR 72076-3837 |
| Mailing Address |
415 Rogers Ave Fort Smith AR 72901-1903 |
| Practice Telephone | 5019825545 |
| Practice Fax Number | 5019820016 |
| Mailing Telephone | 4797834672 |
| Mailing Fax Number | 4797832217 |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2020-04-20 |
| Authorized Official Name | MR. JERRY D SAMS (MEMBER) |
| Authorized Official Telephone | 4797834672 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 502 | AR | Nursing & Custodial Care Facilities |
| Street Address |
1500 GRAHAM RD |
| City | JACKSONVILLE |
| State | AR |
| Zip Code | 72076-3837 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073877601 | Michelle M Collins | Physical Therapist | 1500 Graham Rd, Jacksonville, AR 72076-3837 | 2012-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598396046 | Jennifer Michelle Price | Licensed Practical Nurse | 2400 West Main, Jacksonville, AR 72076 | 2020-02-03 |
| 1912464009 | Stat Home Health - Cenark LLC | Home Health | 1410 Braden Street, Jacksonville, AR 72076 | 2019-02-25 |
| 1649797671 | Caring Hearts Counseling, LLC | Case Management | 111 Marble Drive, Jacksonville, AR 72076 | 2017-08-30 |
| 1376071340 | Anne Elizabeth Houtchens | Speech-Language Pathologist | 2701 Tp White Drive, Jacksonville, AR 72076 | 2017-06-02 |
| 1881140648 | Jacksonville North Pulaski School District | Local Education Agency (LEA) | 1414 West Main, Jacksonville, AR 72076 | 2016-08-31 |
| 1134599772 | Jeremiah Melson Fleeman | Occupational Therapist | 2701 Tpwhite Drive, Jacksonville, AR 72076 | 2015-09-25 |
| 1821424565 | Kasey Michele Leeson | Social Worker | 2520 W. Main St., Jacksonville, AR 72076 | 2013-09-25 |
| 1407104052 | Cesalie Deonne Wallace | Nurse Practitioner | 3000 North First Street, Jacksonville, AR 72076 | 2012-08-29 |
| 1952660995 | Joshua Aaron Hill | Case Manager/Care Coordinator | 2126 N. 1st St Suite F, Jacksonville, AR 72076 | 2012-05-11 |
| 1396023156 | Syreeta Tucker | Case Manager/Care Coordinator | 1109 Burman, Jacksonville, AR 72076 | 2011-07-28 |
| Find all providers in zip 72076 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902404668 | Tambolina Services Community Resident Home, Inc | Assisted Living Facility | 6285 Cranberry Ln W, Jacksonville, FL 32244-2559 | 2020-10-15 |
| 1316552284 | Enhanced Universal Care Alf | Assisted Living Facility | 10967 Key Haven Blvd, Jacksonville, FL 32218-4463 | 2020-09-08 |
| 1710527270 | Rosecastle of Jacksonville LLC | Assisted Living Facility | 8929 R G Skinner Pkwy, Jacksonville, FL 32256-9724 | 2020-01-13 |
| 1891353777 | V & K Horizons | Assisted Living Facility | 7019 Mark St, Jacksonville, FL 32210-4889 | 2019-06-05 |
| 1144784638 | Carole Stallworth | Assisted Living Facility | 5116 Mcmanus Dr, Jacksonville, FL 32210-6353 | 2019-01-29 |
| 1467921569 | Heart To Heart LLC | Assisted Living Facility | 9378 Arlignton Expressway, Ste 218, Jacksonville, FL 32225 | 2018-11-19 |
| 1073090437 | Lashonda Oglesby | Assisted Living Facility | 6313 Arlington Rd, Jacksonville, FL 32211-5423 | 2018-07-27 |
| 1831697218 | Cortney Irene Matthews | Assisted Living Facility | 3109 Gilmore St, Jacksonville, FL 32205-5516 | 2018-01-31 |
| 1093222515 | Anthem Lakes | Assisted Living Facility | 905 Assisi Ln, Jacksonville, FL 32233-2972 | 2018-01-05 |
| 1831608975 | Silver Shores Living, Inc | Assisted Living Facility | 2317 Gilmore St, Jacksonville, FL 32204-3119 | 2017-09-20 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 72076 |
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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.