SALEM VILLAGES MRDD, INC. (NPI# 1861560385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861560385 |
| Entity Type | Organization |
| Organization Name | SALEM VILLAGES MRDD, INC. |
| Practice Address |
4748 Tunis St Jacksonville FL 32205-7379 |
| Mailing Address |
10140 Linn Station Rd Louisville KY 40223-3813 |
| Practice Telephone | 3523720130 |
| Mailing Telephone | 8008660860 |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2011-01-03 |
| 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 | 028563300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760540017 | Salem Villages Mrdd, Inc. | Intermediate Care Facility, Mentally Retarded | 140 Claudia Dr, Jacksonville, FL 32218-4004 | 2006-12-05 |
| 1467520635 | Salem Villages Mrdd, Inc. | Intermediate Care Facility, Mentally Retarded | 930 Sw Spring Ln, Lake City, FL 32025-5082 | 2006-12-04 |
| 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 |
4748 TUNIS ST |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32205-7379 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629404819 | Salem Homes of Florida, Inc. | Intermediate Care Facility, Mentally Retarded | 4748 Tunis St, Jacksonville, FL 32205-7379 | 2013-09-19 |
| 1013189836 | Rescare, Inc. | Intermediate Care Facility, Mentally Retarded | 4748 Tunis St, Jacksonville, FL 32205-7379 | 2008-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003466830 | Brandon Neil Hillard | Registered Nurse | 1260 Mcduff Ave. South, Suite 4, Jacksonville, FL 32205 | 2019-09-13 |
| 1720436363 | Ericka Sampson | Massage Therapist | 6859 Lenox Ave., Suite 6, Jacksonville, FL 32205 | 2016-05-24 |
| 1578921631 | Northstar Counseling | Counselor | 1672 Pershing Rd, Jacksonville, FL 32205 | 2016-02-04 |
| 1649645144 | Magaly Perez-cruz | Speech-Language Pathologist | 4101-1 College Street, Jacksonville, FL 32205 | 2015-12-09 |
| 1639448723 | First Choice Adult Daycare and Home Health Ca | Specialist | 5336 Quan Drive, Jacksonville, FL 32205 | 2011-12-20 |
| 1437434222 | Christopher Styer | Pharmacist | 654 Casset Ave, Jacksonville, FL 32205 | 2011-10-12 |
| 1871827279 | April Marie Felton | Nurse Practitioner | 500 E. Adams Street, Bay Street Health Center, Jacksonville, FL 32205 | 2009-10-01 |
| 1922244821 | Danielle Marie Sergent | Physical Therapist | 5222 Lenox Ave., Jacksonville, FL 32205 | 2008-12-23 |
| 1427181775 | Lapp & Associates Behavioral Counselind Ctr | Counselor | 931 Cassat Avenue, Jacksonville, FL 32205 | 2007-03-14 |
| 1629143326 | Elias Moussa Sargi | Dentist | 2700 Riverside Avenue, Ste 10, Jacksonville, FL 32205 | 2006-11-21 |
| Find all providers in zip 32205 | ||||
| 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 |
| 1760540017 | Salem Villages Mrdd, Inc. | Intermediate Care Facility, Mentally Retarded | 140 Claudia Dr, Jacksonville, FL 32218-4004 | 2006-12-05 |
| 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 | 32205 |
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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.