LARUE ESTATES NPI 1124533948

NPI Information

NPI: 1124533948
Provider Name: LARUE ESTATES

Doing Business As: LARUE ESTATES

Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
8426 DELAWARE AVE
JACKSONVILLE, FL
ZIP 32208
Phone: (904) 370-3575
Get Directions

LARUE ESTATES is a community based residential treatment facility, intellectual and/or developmental disabilities in Jacksonville, FL. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. LARUE ESTATES NPI is 1124533948. The provider is registered as an organization entity type.
The provider Is Doing Business As Larue Estates.

The provider's business location address is:

8426 DELAWARE AVE
JACKSONVILLE, FL
ZIP 32208-841
Phone: (904) 370-3575
Fax: (904) 683-0147

The provider's authorized official is Johnel Griggs .
The authorized official title is Owner and has the following contact phone number (904) 370-3575.

The enumeration date for this NPI number is 12/4/2017 and was last updated on 12/4/2017.

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 State	Primary
1	251E00000X	Home Health			No
2	320800000X	Community Based Residential Treatment Facility, Mental Illness			No
3	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		FLORIDA	Yes
4	385HR2060X	Respite Care	Respite Care, Intellectual and/or Developmental Disabilities		No
5	253Z00000X	In Home Supportive Care			No
6	251S00000X	Community/Behavioral Health			No

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	1508222076	MEDICAID	FLORIDA

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

NPI Synchronization or Removal

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