River Garden Hebrew Home For The Aged

LBN: River Garden Hebrew Home For The Aged
River Garden Hebrew Home For The Aged is an health care organization with primary practice located at 11401 Old Saint Augustine Rd , Jacksonville FL 32258. The organization recently has 7 registered licenses in different health care specialties including Agencies / Home Health, Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, Nursing & Custodial Care Facilities / Skilled Nursing Facility, Suppliers / Nursing Facility Supplies, Suppliers / Parenteral & Enteral Nutrition, Suppliers / Pharmacy, Suppliers / Long Term Care Pharmacy. Nursing & Custodial Care Facilities / Skilled Nursing Facility is the primary health care specialty. River Garden Hebrew Home For The Aged can be contacted via phone (904) 260-1818, or through Goetz, Martin Alan via phone (904) 260-1818.

Contact Information

Primary practice address
11401 Old Saint Augustine Rd Jacksonville FL 32258
Phone: (904) 260-1818
Fax: (904) 260-9733
Website:
Map and Directions
Authorized official contact:
Name: Goetz, Martin Alan MS, MPA, NHA
Phone: (904) 260-1818

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Health 251E00000X HHA299991334 Florida
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X SNF1476096 Florida
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X SNF1476096 Florida
Suppliers / Nursing Facility Supplies 332BN1400X SNF1476096 Florida
Suppliers / Parenteral & Enteral Nutrition 332BP3500X SNF1476096 Florida
Suppliers / Pharmacy 333600000X PH2050 Florida
Suppliers / Pharmacy 333600000X PH13972 Florida
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1669479192
LBN Legal business name River Garden Hebrew Home For The Aged
DBA Doing business as
Authorized official Goetz, Martin Alan MS, MPA, NHA
Entity Organization
Organization subpart 1 No
Enumeration date Jun 30th, 2005
Last updated Sep 23rd, 2022 - about 2 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 1669479192 NPPES
Florida MEDICAID 020085900
Florida MEDICAID 102186900

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