AGNES STREET HOME FOR THE ELDERLY
NPI 1275970204
Assisted Living Facility in Jacksonville, FL

Q: What is Agnes Street Home For The Elderly's NPI number?

The NPI number for Agnes Street Home For The Elderly is 1275970204. It was assigned to this organization in the NPPES registry on May 31, 2013.

Q: What is Agnes Street Home For The Elderly's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since May 31, 2013

1346 AGNES ST, JACKSONVILLE, FL 32208(904) 766-7651(904) 766-7668 Get Directions Write a Review

NPPES record last updated: May 31, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Agnes Street Home For The Elderly NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AGNES STREET HOME FOR THE ELDERLY (NPI 1275970204) is a healthcare organization registered as an assisted living facility in Jacksonville, Florida and active in the NPI registry since May 2013. The organization lists Atakelte Admasu, Owner/administrator, as its authorized official.

NPPES Registry Identity

NPI1275970204

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameAGNES STREET HOME FOR THE ELDERLY

Location Address1346 AGNES STJacksonville, FL 32208-3302

Mailing Address1346 Agnes StJacksonville, FL 32208-3302 · (904) 766-7651 · Fax (904) 766-7668

Phone(904) 766-7651

Fax(904) 766-7668

Organization SubpartNo

Authorized OfficialAtakelte AdmasuOwner/administrator · (904) 766-7651

Enumeration DateMay 31, 2013

✔ NPI 1275970204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in FL · AL5745

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

1346 AGNES ST, Jacksonville, FL 32208

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Other Identifiers 1

Medicaid142605200FL

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Agnes Street Home For The Elderly's NPI number?

The NPI number for Agnes Street Home For The Elderly is 1275970204. It was assigned to this organization in the NPPES registry on May 31, 2013.

Where is Agnes Street Home For The Elderly located?

Agnes Street Home For The Elderly is located at 1346 Agnes St, Jacksonville, FL 32208. The listed phone number is (904) 766-7651.

What is Agnes Street Home For The Elderly's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Agnes Street Home For The Elderly was last updated on May 31, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.