OrganizationActive
Breakwater Adult Family Care Home LLC
NPI 1356407704 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Dunnellon, FL
Provider details
- NPI number
- 1356407704
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Vince Jacobs, Owner(352) 598-0288
- License
- 6905655 (FL)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense 6905655 (FL)
Residential Treatment Facilities
Practice location
22699 Sw Breakwater Blvd
Dunnellon, FL 34431-4039
Phone: (352) 401-7699
Fax: (352) 401-7698
Approximate (ZIP-level) locationGet directions
Mailing address
22699 Sw Breakwater Blvd
Dunnellon, FL 34431-4039
Registry dates
- Enumerated
- 2006-12-29
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.