SALEM VILLAGES MRDD, INC. (NPI# 1760540017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760540017 |
| Entity Type | Organization |
| Organization Name | SALEM VILLAGES MRDD, INC. |
| Practice Address |
140 Claudia Dr Jacksonville FL 32218-4004 |
| Mailing Address |
10140 Linn Station Rd Louisville KY 40223-3813 |
| Practice Telephone | 3523720130 |
| Mailing Telephone | 8008660860 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2010-12-09 |
| Authorized Official Name | MS. DEENA OMBRES (PRIVACY OFFICER) |
| Authorized Official Telephone | 5023942387 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 028069100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467520635 | Salem Villages Mrdd, Inc. | Intermediate Care Facility, Mentally Retarded | 930 Sw Spring Ln, Lake City, FL 32025-5082 | 2006-12-04 |
| 1861560385 | Salem Villages Mrdd, Inc. | Intermediate Care Facility, Mentally Retarded | 4748 Tunis St, Jacksonville, FL 32205-7379 | 2006-12-01 |
| 1669540159 | Salem Villages Mrdd, Inc. | Intermediate Care Facility, Mentally Retarded | 247 Plaza Oval, Casselberry, FL 32707-2934 | 2006-12-01 |
| 1508934076 | Salem Villages Mrdd, Inc. | Intermediate Care Facility, Mentally Retarded | 3841 Se 2nd St, Ocala, FL 34471-3022 | 2006-12-01 |
| 1760550297 | Salem Villages Mrdd, Inc. | Intermediate Care Facility, Mentally Retarded | 529 Nw 19th St, Gainesville, FL 32603-1509 | 2006-12-01 |
| 1306914858 | Salem Villages Mrdd, Inc. | Intermediate Care Facility, Mentally Retarded | 1329 Bessent Rd, Starke, FL 32091-3607 | 2006-12-01 |
| 1548338023 | Salem Villages Mrdd, Inc. | Intermediate Care Facility, Mentally Retarded | 1604 Coletta Dr, Orlando, FL 32807-3514 | 2006-12-01 |
| 1659449130 | Salem Villages Mrdd, Inc. | Intermediate Care Facility, Mentally Retarded | 71 Rosewood Ave, Ormond Beach, FL 32174-5522 | 2006-12-01 |
| 1104994672 | Salem Villages Mrdd, Inc. | Intermediate Care Facility, Mentally Retarded | 5321 Se 107th Pl, Belleview, FL 34420-3231 | 2006-12-01 |
| 1578631073 | Salem Villages Mrdd, Inc. | Intermediate Care Facility, Mentally Retarded | 27566 Suffridge Dr, Bonita Springs, FL 34135-4527 | 2006-12-01 |
| Street Address |
140 CLAUDIA DR |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32218-4004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700212990 | Salem Homes of Florida, Inc. | Intermediate Care Facility, Mentally Retarded | 140 Claudia Dr, Jacksonville, FL 32218-4004 | 2013-09-19 |
| 1487826202 | Rescare, Inc. | Intermediate Care Facility, Mentally Retarded | 140 Claudia Dr, Jacksonville, FL 32218-4004 | 2008-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684170 | Damon Lamar Baker | Nurse Practitioner | 12533 Sampson Rd, Jacksonville, Fl, FL 32218 | 2020-09-21 |
| 1578199303 | First Coast Health Ventures, LLC | Skilled Nursing Facility | 15480 Max Leggett Parkway, Jacksonville, FL 32218 | 2020-03-12 |
| 1932679594 | Alaina Rachelle Stanley | Counselor | 11683 Spring Board Dr, Jacksonville, FL 32218 | 2018-11-27 |
| 1508345133 | War Cry Ministry Inc | Counselor | 435 Eric Ave, Jacksonville, FL 32218 | 2018-08-14 |
| 1285111484 | St Vincent's Full Service Urgent Care, LLC | Clinic/Center | 15510 Max Leggett Parkway, Ste A, Jacksonville, FL 32218 | 2018-07-20 |
| 1427544501 | Derrick Roberts | Behavioral Analyst | 11302 Forestdale Rd, Jacksonville, FL 32218 | 2018-07-02 |
| 1215420229 | Companion & Compassion LLC | Home Health | 856 Poydras Ln W, Jacksonville, FL 32218 | 2018-06-13 |
| 1952894784 | Michael Alexander Aaro | Dentist | 1840 Dunn Ave Ste 3, Jacksonville, FL 32218 | 2018-06-06 |
| 1235629445 | Melissa C Moree | Counselor | 13453 Main St. North, Suite 104, Jacksonville, FL 32218 | 2018-05-14 |
| 1861900896 | Sheila Nowlin | Physical Therapist | 1034 Dunn Ave, Jacksonville, FL 32218 | 2018-01-11 |
| Find all providers in zip 32218 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366614281 | Community Living Options Inc | Intermediate Care Facility, Mentally Retarded | 426 E Douglas, Jacksonville, IL 62650-2114 | 2008-04-01 |
| 1447422373 | Community Living Options Inc | Intermediate Care Facility, Mentally Retarded | 408 Anna Street, Jacksonville, IL 62650-2847 | 2008-04-01 |
| 1568634699 | Community Living Options Inc | Intermediate Care Facility, Mentally Retarded | 2 Eisenhower Drive, Jacksonville, IL 62650-1735 | 2008-03-28 |
| 1912179045 | Community Living Options Inc | Intermediate Care Facility, Mentally Retarded | 324 E Douglas Street, Jacksonville, IL 62650-2047 | 2008-03-28 |
| 1871765222 | Community Living Options Inc | Intermediate Care Facility, Mentally Retarded | 826 W Lafayette, Jacksonville, IL 62650-1835 | 2008-03-26 |
| 1609045897 | Alvin Eades Center, Inc. | Intermediate Care Facility, Mentally Retarded | 1000a W Michigan Ave, Jacksonville, IL 62650-3117 | 2008-02-21 |
| 1861560385 | Salem Villages Mrdd, Inc. | Intermediate Care Facility, Mentally Retarded | 4748 Tunis St, Jacksonville, FL 32205-7379 | 2006-12-01 |
| 1881762375 | Salem Villages Mrdd, Inc. | Intermediate Care Facility, Mentally Retarded | 11818 High Desert Ct, Jacksonville, FL 32218-3629 | 2006-12-01 |
| 1013945898 | Access | Intermediate Care Facility, Mentally Retarded | 5656 N. Jackson, Jacksonville, TX 75766 | 2006-06-29 |
| 1275969461 | Salem Homes of Florida, Inc. | Intermediate Care Facility, Mentally Retarded | 11818 High Desert Ct, Jacksonville, FL 32218-3629 | 2013-09-19 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32218 |
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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.