Eisenhower Jacksonville Group Llc

LBN: Eisenhower Jacksonville Group Llc
Eisenhower Jacksonville Group Llc is an health care organization with primary practice located at 2671 Huffman Blvd , Jacksonville FL 32246-4056. The organization recently has 9 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Brain Injury Medicine, Agencies / Case Management, Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, Residential Treatment Facilities / Residential Treatment Facility, Physical Disabilities, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, Residential Treatment Facilities / Psychiatric Residential Treatment Facility. Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty. Eisenhower Jacksonville Group Llc can be contacted via phone (734) 677-0070, or through Pendley, Ann via phone (734) 677-0070.

Contact Information

Primary practice address
2671 Huffman Blvd Jacksonville FL 32246-4056
Phone: (734) 677-0070
Fax: (734) 677-0890
Website:
Map and Directions
Authorized official contact:
Name: Pendley, Ann Master of Science in Nursing (MSN)
Phone: (734) 677-0070

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Brain Injury Medicine 2081P0301X
Agencies / Case Management 251B00000X
Agencies / Community/Behavioral Health 251S00000X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X
Residential Treatment Facilities / Residential Treatment Facility, Physical Disabilities 320700000X
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X
Residential Treatment Facilities / Psychiatric Residential Treatment Facility 323P00000X

Profile Details

NPI number 1417494485
LBN Legal business name Eisenhower Jacksonville Group Llc
DBA Doing business as
Authorized official Pendley, Ann Master of Science in Nursing (MSN)
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 27th, 2017
Last updated Sep 28th, 2021 - about 3 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 1417494485 NPPES
Florida Other 1558544130 TRANSITIONAL LIVING FACILITY

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