OrganizationActive
A Premier Living Care Center LLC
NPI 1700579265 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Jacksonville, FL
Provider details
- NPI number
- 1700579265
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Debra Avery, Ceo(904) 485-0978
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
1853 Broadway Ave
Jacksonville, FL 32209-7507
Phone: (904) 485-0978
Approximate (ZIP-level) locationGet directions
Mailing address
4720 Salisbury Rd
Jacksonville, FL 32256-6101
Registry dates
- Enumerated
- 2023-05-31
- Last updated
- 2025-10-15
- Certified
- 2025-10-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.