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General NPI Number Information
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NPI Number | 1457609984
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Entity Type | Organization
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Legal Business Name | RIVER GARDEN HEBREW HOME FOR THE AGED
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 11401 OLD SAINT AUGUSTINE RD
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City | JACKSONVILLE
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State | FL
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Zip | 32258-1402
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Country | US
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Telephone | 904-886-8409
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Fax | 904-880-2968
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Provider Business Mailing Address
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Address Line | 11401 OLD SAINT AUGUSTINE RD
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City | JACKSONVILLE
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State | FL
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Zip | 32258-1402
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Country | US
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Telephone | 904-886-8409
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Fax | 904-880-2968
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Authorized Official
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Title or Position | CEO
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Name | MS. MAURI MIZRAHI
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Credential | LNHA
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Telephone | 904-260-1818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HHA299991334
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License Number State | FL
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