LATRENA M THOMAS (NPI# 1760971923) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760971923 |
| Entity Type | Individual |
| Full Name | LATRENA M THOMAS |
| Practice Address |
14091 Summer Breeze Dr E Jacksonville FL 32218-8913 |
| Mailing Address |
Po Box 77581 Jacksonville FL 32226-7581 |
| Practice Telephone | 8045025840 |
| Practice Fax Number | 9044858541 |
| Mailing Telephone | 8045025840 |
| Mailing Fax Number | 9044858541 |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2018-05-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 15IV043 | FL | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 019341700 | 05 |
| Street Address |
14091 SUMMER BREEZE DR E |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32218-8913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972092310 | Shequila Thomas | Licensed Practical Nurse | 14091 Summer Breeze Dr E, Jacksonville, FL 32218-8913 | 2018-05-01 |
| 1164911509 | Rodrea Brown | Licensed Practical Nurse | 14091 Summer Breeze Dr E, Jacksonville, FL 32218-8913 | 2018-05-01 |
| 1316436751 | Shakira Richburgh | Licensed Practical Nurse | 14091 Summer Breeze Dr E, Jacksonville, FL 32218-8913 | 2018-05-01 |
| 1285123638 | Anoya Glover | Licensed Practical Nurse | 14091 Summer Breeze Dr E, Jacksonville, FL 32218-8913 | 2018-05-01 |
| 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 | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184932956 | L'arche Harbor House, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 700 Arlington Rd N, Jacksonville, FL 32211-7306 | 2010-09-15 |
| 1649426065 | Marjorie G. Cupp | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1545 Parkwood St, Jacksonville, FL 32207-5476 | 2008-08-18 |
| 1447382387 | Houseofdavid | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 209 Toni Dr, Jacksonville, NC 28546-4803 | 2007-03-09 |
| 1528198892 | Hampton Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 100 Cypress Ct, Jacksonville, NC 28540-4029 | 2007-03-06 |
| 1497882195 | Genesis Therapeutic Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 99 Village Dr Ste 12, Jacksonville, NC 28546-7060 | 2007-02-28 |
| 1831224849 | Irving Family Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 112 Lance Ct, Jacksonville, NC 28546-8640 | 2007-02-22 |
| 1639204233 | Moore Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 232 Newport Dr, Jacksonville, NC 28540-4005 | 2007-02-22 |
| 1720141542 | National Mentor Healthcare,llc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3615 Hodges Blvd, Jacksonville, FL 32224-1288 | 2006-12-19 |
| 1265693584 | Linda Elizabeth Gibson | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 180 Coastal Ln, Jacksonville, NC 28546-6761 | 2008-06-19 |
| 1154465243 | Bushnell Dix Hill Jones 694110 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1201 S Main St, Jacksonville, IL 62650-3339 | 2007-02-20 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32218 |
Please comment or provide details below to improve the information on LATRENA M THOMAS.
| 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.