MEDICARE: R.O.B. THE FOUNDATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1578421053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R.O.B. THE FOUNDATION

Provider Business Mailing Address
First Line	:	7707 MERRILL RD #8309
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32277
Country	:	US
Telephone Number	:	904-610-5628
Fax Number	:

Provider Business Practice Location Address
First Line	:	7707 MERRILL RD UNIT 8309
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32277
Country	:	US
Telephone Number	:	904-610-5628
Fax Number	:

Authorized Official
Title or Position	:	EXEC DIRECTOR
Name	:	KENKENYANA ROBERTS
Credential	:
Telephone Number	:	904-610-5623

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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