3455 San Pablo Rd S Tenant LLC
NPI 1205664349ActiveOrganization· Assisted Living Facility· Jacksonville, FL
Assisted Living Facility in Jacksonville, Florida, registered in NPPES in July 2024. The authorized official on file is Sharon Makowsky, Authorized Representative.
Overview
| NPI | 1205664349 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 22, 2024 |
| Last updated in NPPES | Jul 22, 2024 |
| Certified by provider | Jun 28, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Assisted Living Facility Primary | 310400000X | — | — |
| Alzheimer Center (Dementia Center) | 311500000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Assisted Living Facility providers in Jacksonville
- 1265104855
- 1508239047
- 1982977443
- 1497107437
- 1013397850
- 1275970204
- 1932626751
- 1689926990
- 1285323758
- 1902595234
- 1295114221
- 1447639216