Agnes Street Home For The Elderly

LBN: Agnes Street Home For The Elderly
Agnes Street Home For The Elderly is an health care organization with primary practice located at 1346 Agnes St , Jacksonville FL 32208-3302. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. Agnes Street Home For The Elderly can be contacted via phone (904) 766-7651, or through Admasu, Atakelte via phone (904) 766-7651.

Contact Information

Primary practice address
1346 Agnes St Jacksonville FL 32208-3302
Phone: (904) 766-7651
Fax: (904) 766-7668
Website:
Map and Directions
Authorized official contact:
Name: Admasu, Atakelte
Phone: (904) 766-7651

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X AL5745 Florida

Profile Details

NPI number 1275970204
LBN Legal business name Agnes Street Home For The Elderly
DBA Doing business as
Authorized official Admasu, Atakelte
Entity Organization
Organization subpart 1 No
Enumeration date May 31st, 2013
Last updated May 31st, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275970204 NPPES
Florida MEDICAID 142605200

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