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PREMIER ASSISTED LIVING FACILITY, LLC
NPI 1962140210
Assisted Living Facility in Orange Park, FL

Active since May 26, 2022CLIA 10D2309118 · Waiver
319 ELDRIDGE AVE, ORANGE PARK, FL 32073(904) 541-4605(904) 644-8378 Get Directions Write a Review

NPPES record last updated: May 26, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Premier Assisted Living Facility, Llc NPPES

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

PREMIER ASSISTED LIVING FACILITY, LLC (NPI 1962140210) is a healthcare organization registered as an assisted living facility in Orange Park, Florida and active in the NPI registry since May 2022. The organization holds a CLIA Waiver certificate valid through August 8, 2026 and lists Ashraf Gayed Andrawis, Owner, as its authorized official.

NPPES Registry Identity

NPI1962140210
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NamePREMIER ASSISTED LIVING FACILITY, LLC
Location Address319 ELDRIDGE AVEOrange Park, FL 32073-2956
Mailing Address138 Passage DrFleming Island, FL 32003-8077 · (904) 451-5570 · Fax (904) 644-8378
Phone(904) 541-4605
Fax(904) 644-8378
Organization SubpartNo
Authorized OfficialAshraf Gayed AndrawisOwner · (904) 451-5570
Enumeration DateMay 26, 2022
NPPES CertifiedMay 25, 2022
✔ NPI 1962140210 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
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.

319 ELDRIDGE AVE, Orange Park, FL 32073
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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 10D2309118

Premier Assisted Living Facility, LLC · Orange Park, FL
Active · expires Aug 8, 2026
CLIA Number10D2309118
Laboratory TypeAssisted Living Facility
Certificate Effective DateAugust 9, 2024
Certificate Expiration DateAugust 8, 2026
Laboratory DirectorJessica M. Vance
Laboratory Phone(904) 541-4605
Laboratory LocationPremier Assisted Living Facility, LLC319 Eldridge Ave, Orange Park, FL 32073
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

VISION MANOT, INC
Assisted Living Facility
319 ELDRIDGE AVE
ORANGE PARK, FL 32073
Clay County (904) 662-2331

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 Premier Assisted Living Facility, LLC's NPI number?

The NPI number for Premier Assisted Living Facility, LLC is 1962140210. It was assigned to this organization in the NPPES registry on May 26, 2022.

Where is Premier Assisted Living Facility, LLC located?

Premier Assisted Living Facility, LLC is located at 319 Eldridge Ave, Orange Park, FL 32073. The listed phone number is (904) 541-4605.

What is Premier Assisted Living Facility, LLC's specialty?

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

Does Premier Assisted Living Facility, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2309118) is associated with this NPI, valid through August 8, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Premier Assisted Living Facility, LLC was last updated on May 26, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.