Organization
RIVER GARDEN HEBREW HOME FOR THE AGED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAURI MIZRAHI LNHA (CEO)
(904) 260-1818
Entity
Organization
Contact information
Practice address
11401 OLD SAINT AUGUSTINE RD, JACKSONVILLE, FL 32258
(904) 260-1818
(904) 260-9733
Mailing address
11401 OLD SAINT AUGUSTINE RD # 106, JACKSONVILLE, FL 32258-4500
(904) 260-1818
(904) 260-9733
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
HHA299991334
FL
313M00000X
Nursing Facility/Intermediate Care Facility
SNF1476096
FL
314000000X
Skilled Nursing Facility
Primary
SNF1476096
FL
332BN1400X
Nursing Facility Supplies (DME)
SNF1476096
FL
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
SNF1476096
FL
333600000X
Pharmacy
PH13972
FL
333600000X
Pharmacy
PH2050
FL
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020085900
—
FL
05
—
102186900
—
FL
Enumeration date
06/30/2005
Last updated
01/26/2026
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