LAVON M. GAINEY NPI 1396298915

NPI Information

NPI: 1396298915
Provider Name: LAVON M. GAINEY

Doing Business As: QUALITY LIFE CENTER OF JACKSONVILLE

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
11265 ALUMNI WAY
JACKSONVILLE, FL
ZIP 32246
Phone: (904) 518-6090
Get Directions

LAVON M. GAINEY is a community based residential treatment facility mental illness in Jacksonville, FL. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. LAVON M. GAINEY NPI is 1396298915. The provider is registered as an organization entity type.
The provider Is Doing Business As Quality Life Center Of Jacksonville.

The provider's business location address is:

11265 ALUMNI WAY
JACKSONVILLE, FL
ZIP 32246-685
Phone: (904) 518-6090

The provider's authorized official is Marcus De Carvalho .
The authorized official title is Medical Director and has the following contact phone number (904) 398-2020.

The enumeration date for this NPI number is 8/1/2016 and was last updated on 8/1/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	MH13303	OTHER	FLORIDA	MENTAL HEALTH LICENSURE #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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