COLLETTE KATRELL HOLMES (NPI# 1932577970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932577970 |
| Entity Type | Individual |
| Full Name | COLLETTE KATRELL HOLMES |
| Practice Address |
2821 Hunt St Jacksonville FL 32254-4003 |
| Practice Telephone | 9046737212 |
| Mailing Telephone | 9046737212 |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2015-09-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | AL12677 | FL | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689874216 | Collette Angelle Holmes | Occupational Therapist | 759 E Linden Ave, Salt Lake City, UT 84102-2210 | 2007-07-22 |
| Street Address |
2821 HUNT ST |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32254-4003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174853246 | J & J Holistic Care Center | Assisted Living Facility | 2821 Hunt St, Jacksonville, FL 32254-4003 | 2010-01-12 |
| 1467821512 | Grace Home Living Facility LLC | Assisted Living Facility | 2821 Hunt St, Jacksonville, FL 32254-4003 | 2015-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730673385 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1301 W Palm Ave Ste 210, Jacksonville, FL 32254 | 2018-06-18 |
| 1578072112 | Jules M Jean-pierre | Counselor | 2392 North Edgewood Avenue, Jacksonville, FL 32254 | 2017-09-27 |
| 1356869051 | Volaura Shanae Anderson | Counselor | 590 Ellis Rd, Jacksonville, FL 32254 | 2017-09-01 |
| 1962928291 | Angel Spivie | Counselor | 590 Ellis Road South Building 4, Jacksonville, FL 32254 | 2017-08-18 |
| 1376072777 | Tarkeshia Shuman | Contractor | 3150 Broadway Ave, Jacksoville, FL 32254 | 2017-06-08 |
| 1770931636 | Mamie Faith Peterson-mclaurn | Home Health | 2747 Sophia St, Jax, FL 32254 | 2016-06-01 |
| 1760803373 | Marian Lavonne Jones | Custodial Care Facility | 3501 Centerhill Dr. North, Jacksonville, FL 32254 | 2013-12-27 |
| 1659543981 | Monique Bosque-perez | Family Medicine | 781 Edgewood Ave N, Ufjp Commonwealth Family Practice, Jacksonville, FL 32254 | 2008-03-26 |
| 1508906652 | James Keith Riesz | Physical Therapist | 800 Lomax Street, Suite 105, Jacksonville, FL 32254 | 2007-02-07 |
| 1003903865 | Sabrina F Sessions | Pharmacist | 5050 Edgewood Court, Jacksonville, FL 32254 | 2006-10-05 |
| Find all providers in zip 32254 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508291683 | Spirit of Excellence Community Outreach, Inc | Community Based Residential Treatment Facility, Mental Illness | 510 Crissy Dr, Jacksonville, NC 28540-9183 | 2013-09-09 |
| 1326383852 | Operation Community Restore | Community Based Residential Treatment Facility, Mental Illness | 204 N Washington St, Jacksonville, FL 32202-2809 | 2012-12-10 |
| 1558634113 | A.l.l. Focus Inc | Community Based Residential Treatment Facility, Mental Illness | 11115 Key Haven Blvd, Jacksonville, FL 32218-4488 | 2012-02-13 |
| 1063601565 | A.l.l. Focus Inc | Community Based Residential Treatment Facility, Mental Illness | 6816 Bloxham Ave, Jacksonville, FL 32208-4841 | 2007-10-20 |
| 1598953408 | Pearls Family Care Home #2 | Community Based Residential Treatment Facility, Mental Illness | 107 Ash Ct, Jacksonville, NC 28546-8503 | 2007-10-05 |
| 1174710529 | Pearls Family Care Home # 4 | Community Based Residential Treatment Facility, Mental Illness | 102 Ash Place, Jacksonville, NC 28546 | 2007-10-01 |
| 1104013994 | Pearls Family Care Home #3 | Community Based Residential Treatment Facility, Mental Illness | 105 Ash Ct, Jacksonville, NC 28546-8503 | 2007-09-26 |
| 1528107505 | .martha's Group Homes, Inc. | Community Based Residential Treatment Facility, Mental Illness | 303 S Shore Dr, Jacksonville, NC 28540-5647 | 2007-02-06 |
| 1306484464 | Roxanne Gordon | Community Based Residential Treatment Facility, Mental Illness | 3027 San Diego Rd, Jacksonville, FL 32207-3691 | 2019-12-19 |
| 1396298915 | Lavon M. Gainey | Community Based Residential Treatment Facility, Mental Illness | 11265 Alumni Way, Jacksonville, FL 32246-6685 | 2016-08-01 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32254 |
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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.