NPI Portal NPI Lookup & Verification

Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Agnes Street Home for the Elderly

Assisted Living Facility in Jacksonville, FL · enumerated 2013 · authorized official Atakelte Admasu, Owner/Administrator.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1275970204

Verified

See something wrong? Report a correction

Registry record

Entity type Organization (Type 2)
Legal business name Agnes Street Home for the Elderly
Practice address 1346 Agnes St, Jacksonville, FL, 32208
Phone (904) 766-7651
Fax (904) 766-7668
Enumeration date May 31, 2013
Last updated in NPPES May 31, 2013

Taxonomy & classification

310400000X Assisted Living Facility Nursing & Custodial Care Facilities · License AL5745 (FL) Primary

Authorized official

Name Atakelte Admasu
Title Owner/Administrator
Phone (904) 766-7651

Other identifiers

Identifier Type State Issuer
142605200 Medicaid FL -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What is the NPI number for Agnes Street Home for the Elderly?
The NPI for Agnes Street Home for the Elderly is 1275970204, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Agnes Street Home for the Elderly?
NPPES lists Atakelte Admasu (Owner/Administrator) as the authorized official for this organization.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2013-05-31.