RIVER GARDEN HEBREW HOME FOR THE AGED
NPI 1457609984
Home Health in Jacksonville, FL

Q: What is River Garden Hebrew Home For The Aged's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

Active since August 15, 2012CLIA 10D0645129 · Waiver

11401 OLD SAINT AUGUSTINE RD, JACKSONVILLE, FL 32258(904) 886-8409(904) 880-2968 Get Directions Write a Review

NPPES record last updated: January 26, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About River Garden Hebrew Home For The Aged NPPES

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

RIVER GARDEN HEBREW HOME FOR THE AGED (NPI 1457609984) is a healthcare organization registered as a home health in Jacksonville, Florida and active in the NPI registry since August 2012. The organization holds a CLIA Waiver certificate valid through September 4, 2027 and lists Mauri Mizrahi, Ceo, as its authorized official.

NPPES Registry Identity

NPI1457609984

Entity TypeOrganization

Primary Taxonomy251E00000X

Legal Business NameRIVER GARDEN HEBREW HOME FOR THE AGED

Location Address11401 OLD SAINT AUGUSTINE RDJacksonville, FL 32258-1402

Mailing Address11401 Old Saint Augustine RdJacksonville, FL 32258-1402 · (904) 886-8409 · Fax (904) 880-2968

Phone(904) 886-8409

Fax(904) 880-2968

Organization SubpartYes

Authorized OfficialMauri MizrahiCeo · (904) 260-1818

Enumeration DateAugust 15, 2012

Last NPPES UpdateJanuary 26, 2026

NPPES CertifiedJanuary 26, 2026

✔ NPI 1457609984 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome HealthAgencies

Taxonomy Code251E00000X

License✔ Licensed in FL · HHA299991334

Definition

A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

11401 OLD SAINT AUGUSTINE RD, Jacksonville, FL 32258

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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0645129

River Garden Hebrew Home For The Aged · Jacksonville, FL

Active · expires Sep 4, 2027

CLIA Number10D0645129

Laboratory TypeSkilled Nursing Facility/Nursing Facility

Certificate Effective DateSeptember 5, 2025

Certificate Expiration DateSeptember 4, 2027

Laboratory DirectorFranciso I. Martinez Wittinghan

Laboratory Phone(904) 260-1818

Laboratory LocationRiver Garden Hebrew Home For The Aged11401 Old St Augustine Rd, Jacksonville, FL 32258

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEATHER CHEYENNE DORTCH

Physical Therapy Assistant