Unknown Individual – Mental Illness Community Based Residential Treatment Facility, NPI 1700097888

Unknown Individual is a healthcare provider. based in Jacksonville, Florida. specializing in Mental Illness Community Based Residential Treatment Facility. The NPI Number for Unknown Individual is 1700097888

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1700097888
Phone
(904) 899-6300
Address
390 PARK ST
Deactivation Date
21 July 2021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience5
Completeness75
Years active:0State licenses:0Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 390, Park Street, Brooklyn, Jacksonville, Duval County, Florida, 32204, United States

    JACKSONVILLE, FL 322042342

    Phone: (904) 899-6300

    Fax: (904) 899-6383

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32204)

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Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1700097888.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Mental Illness Community Based Residential Treatment Facility. Clinical services aligned with this taxonomy classification.
Where in Florida is Unknown Individual registered?
Use Jacksonville, Florida as the headline location for Unknown Individual here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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