COFFEE & GRACE LLC (NPI# 1750988895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750988895 |
| Entity Type | Organization |
| Organization Name | COFFEE & GRACE LLC |
| Practice Address |
1821 N Pearl St Ste A Jacksonville FL 32206-3663 |
| Mailing Address |
Po Box 77581 Jacksonville FL 32226-7581 |
| Practice Telephone | 9044742192 |
| Practice Fax Number | 9042120128 |
| Mailing Telephone | 9044742192 |
| Mailing Fax Number | 9042120128 |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2020-10-31 |
| Authorized Official Name | MRS. ALYSSA JACOBS (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9044742192 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251J00000X | Nursing Care | Agencies | ||
| N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| N | 385HR2060X |
Respite Care Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
Respite Care Facility | ||
| N | 163W00000X | Registered Nurse | Nursing Service Providers | ||
| N | 163WH0200X |
Registered Nurse Specialization: Home Health |
Nursing Service Providers | ||
| N | 164W00000X | Licensed Practical Nurse | Nursing Service Providers | ||
| Y | 251E00000X | Home Health | Agencies |
| Street Address |
1821 N PEARL ST STE A |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32206-3663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790275543 | Marvin Victor Sindel IIi | Nurse Practitioner | 1241 E 8th St, Jacksonville, FL 32206 | 2018-05-17 |
| 1982126553 | Marcia Camille Holloway | In Home Supportive Care | 647 East 31th Street, Jacksonville, FL 32206 | 2017-07-14 |
| 1407302656 | Tahnita Fleming | Day Training, Developmentally Disabled Services | 1309 Van Buren Street, Jacksonville, FL 32206 | 2016-08-28 |
| 1912202136 | Bishop Home Care, Inc | Clinic/Center | 1627 E 8th Street, Jacksonville, FL 32206 | 2011-01-19 |
| 1407183965 | Richard Adam Crosby | Chiropractor | 4211 North Pearl St., Jacksonville, FL 32206 | 2009-11-04 |
| 1346494903 | Delvenia Renee Mitchell | Specialist | 4515 N Pearl St Apt 2, Jacksonville, FL 32206 | 2008-11-10 |
| 1962662775 | Curtis Michael Bryant | Radiology | 2015 Jefferson Street, University of Florida Proton Institute, Jacksonville, FL 32206 | 2008-06-15 |
| 1932253879 | Gale Marie Cohen-weiss | Social Worker | Veterans Health System, Jacksonville Outpatient Clinic, 1833 Boulevard, Jacksonville, FL 32206 | 2007-01-22 |
| 1396817557 | Bella Caimol Ejercito | Internal Medicine | 4608 Norwood Ave, Jacksonville, FL 32206 | 2006-11-14 |
| 1962584433 | Jessica Ivette Warthen | Pharmacist | 1833 Boluevard, Department of Veterans Affairs; Mental Health Clinic, Jacksonville, FL 32206 | 2006-10-20 |
| Find all providers in zip 32206 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447850185 | Latoya Butler | Home Health | 5710 Lenox Ave Apt 121, Jacksonville, FL 32205-6383 | 2020-10-30 |
| 1871193334 | All Executive Healthcare Agency LLC | Home Health | 841 Prudential Dr Ste 1211, Jacksonville, FL 32207-8329 | 2020-10-26 |
| 1013516335 | Melissa Horne | Home Health | 2426 Lotus Rd E, Jacksonville, FL 32211-4169 | 2020-10-19 |
| 1114525821 | Sep Companion Services | Home Health | 1979 Lane Ave S, Jacksonville, FL 32210-2741 | 2020-10-14 |
| 1235737925 | Concierge Home Care of Jacksonville 2, LLC | Home Health | 4655 Salisbury Rd Ste 110, Jacksonville, FL 32256-0957 | 2020-10-14 |
| 1821696808 | Above and Beyond Solutions LLC | Home Health | 8030 Loch Lomond Ln, Jacksonville, FL 32244-5519 | 2020-10-13 |
| 1891302386 | Deanna Domineck | Home Health | 913 Lord Nelson Blvd, Jacksonville, FL 32218-6755 | 2020-09-28 |
| 1861009359 | A Serene Services LLC | Home Health | 8553 Argyle Business Loop Ste 5e, Jacksonville, FL 32244-6604 | 2020-09-28 |
| 1770199317 | Alpha 1st Home Health Care | Home Health | 1619 Nottingham Knoll Dr, Jacksonville, FL 32225-2665 | 2020-09-18 |
| 1255944682 | Life Assistance and Management Agency | Home Health | 7606 Tarleton Rd, Jacksonville, FL 32208-3433 | 2020-08-25 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32206 |
Please comment or provide details below to improve the information on COFFEE & GRACE LLC.
| 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.