Jacobsladder Family
Assisted Living Facility in Rockledge, FL. Organization (NPI-2).
NPI number1992064729
StatusActive
Last updated in NPPESMay 14, 2012
Details
- NPI
- 1992064729
- Entity type
- Organization (NPI-2)
- Legal business name
- Jacobsladder Family
- Organization subpart
- No
- Enumeration date
- May 14, 2012
- Last updated
- May 14, 2012
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 310400000X | Assisted Living Facility | AL11180 | FL | Yes |
Practice location
946 Brunswick LnRockledge, FL 32955-4070
Phone 321-223-3967
Mailing address
946 Brunswick LnRockledge, FL 32955-4070
Phone 321-223-3967
Authorized official
Karolena Marie Declercq
Administrator
3212233967
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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