Provider Demographics
NPI:1447567540
Name:SECOND BEGINNINGS ALF
Entity Type:Organization
Organization Name:SECOND BEGINNINGS ALF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-743-8283
Mailing Address - Street 1:7306 MAPLE TREE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-2806
Mailing Address - Country:US
Mailing Address - Phone:904-743-8283
Mailing Address - Fax:904-743-0747
Practice Address - Street 1:7306 MAPLE TREE DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-2806
Practice Address - Country:US
Practice Address - Phone:904-743-8283
Practice Address - Fax:904-743-0747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL111033104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness