Healthcare Provider Details

I. General information

NPI: 1750220109
Provider Name (Legal Business Name): FIRST COAST ASSISTED TRANSITION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

863 ARTHUR MOORE DR
GREEN COVE SPRINGS FL
32043-9510
US

IV. Provider business mailing address

5000 US HIGHWAY 17 STE 18
FLEMING ISLAND FL
32003-8250
US

V. Phone/Fax

Practice location:
  • Phone: 904-586-8697
  • Fax: 904-212-0454
Mailing address:
  • Phone: 904-586-8697
  • Fax: 904-212-0454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JONA JANEENE BARBER
Title or Position: OWNER/DIRECTOR
Credential: CSA, CDP, CPRS
Phone: 904-531-3116