Provider Type Icon

HIDDEN OAKS ALF INC NPI 1376896555


NPI Information

NPI: 1376896555
Provider Name: HIDDEN OAKS ALF, INC

Doing Business As: THE SUSAN REWIS HOUSE

Classification: Assisted Living Facility - 3104A0625X
Entity Type: Organization

Specialization: Assisted Living, Mental Illness

Address:
7216 NW 22ND DR
JENNINGS, FL
ZIP 32053
Phone: (386) 938-2097
Get Directions

HIDDEN OAKS ALF, INC is an assisted living and mental illness assisted living facility in Jennings, FL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. HIDDEN OAKS ALF, INC NPI is 1376896555. The provider is registered as an organization entity type.
The provider Is Doing Business As The Susan Rewis House.

The provider's business location address is:

7216 NW 22ND DR
JENNINGS, FL
ZIP 32053-351
Phone: (386) 938-2097
Fax: (386) 938-2636

The provider's authorized official is Wanda M. Law .
The authorized official title is Owner/administrator and has the following contact phone number (386) 938-1149.

The enumeration date for this NPI number is 10/24/2012 and was last updated on 5/4/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13104A0625XAssisted Living FacilityAssisted Living, Mental IllnessAL9631FLORIDAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1693600800MEDICAIDFLORIDA
2140410100MEDICAIDFLORIDA

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.