MEDICARE: SALEM VILLAGES MRDD, INC.

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	315P00000X	Intellectual Disabilities Intermediate Care Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861560385
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALEM VILLAGES MRDD, INC.

Provider Business Mailing Address
First Line	:	10140 LINN STATION RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40223-3813
Country	:	US
Telephone Number	:	800-866-0860
Fax Number	:

Provider Business Practice Location Address
First Line	:	4748 TUNIS ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32205-7379
Country	:	US
Telephone Number	:	352-372-0130
Fax Number	:

Authorized Official
Title or Position	:	PRIVACY OFFICER
Name	:	MS. DEENA OMBRES
Credential	:
Telephone Number	:	502-394-2387

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	01/03/2011

Similar Medicare Providers

1013189836 — RESCARE, INC.
Practice Location Address:

4748 TUNIS ST
JACKSONVILLE, FL
32205-7379

Practice Phone: 904-389-3900
Practice Fax:

1629404819 — SALEM HOMES OF FLORIDA, INC.
Practice Location Address:

4748 TUNIS ST
JACKSONVILLE, FL
32205-7379

Practice Phone: 352-372-0310
Practice Fax:

1366023822 — SUNCOAST NEW OPTIONS TUNIS STREET, LLC
Practice Location Address:

4748 TUNIS ST
JACKSONVILLE, FL
32205-7379

Practice Phone: 919-390-2980
Practice Fax:

1942166871 — SUNRISE COMMUNITY, INC.
Practice Location Address:

4748 TUNIS ST
JACKSONVILLE, FL
32205-7379

Practice Phone: 305-273-3047
Practice Fax: 305-275-3345

1861466641 — BASHIR AHMED M.D.
Practice Location Address:

7901 JAMES ISLAND TRL
JACKSONVILLE, FL
32256-7379

Practice Phone: 904-388-2540
Practice Fax: 904-387-6800

1891141925 — NORTHEAST FLORIDA HEALTH SOLUTION INC.
Practice Location Address:

7901 JAMES ISLAND TRL
JACKSONVILLE, FL
32256-7379

Practice Phone: 904-388-2540
Practice Fax: 904-387-6800

Directions to “SALEM VILLAGES MRDD, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.