Provider Demographics
NPI:1922540160
Name:DAYSPRING SENIOR LIVING LLC
Entity type:Organization
Organization Name:DAYSPRING SENIOR LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-845-7501
Mailing Address - Street 1:PO BOX 1080
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:FL
Mailing Address - Zip Code:32046-1080
Mailing Address - Country:US
Mailing Address - Phone:904-845-2362
Mailing Address - Fax:904-845-2190
Practice Address - Street 1:553600 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:FL
Practice Address - Zip Code:32046-8280
Practice Address - Country:US
Practice Address - Phone:904-845-2362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12925310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAL12925OtherAGENCY FOR HEALTH CARE ADMINISTRATION