Provider Demographics
NPI:1215345160
Name:DESIRE HEALTH CARE CORP.
Entity type:Organization
Organization Name:DESIRE HEALTH CARE CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR, CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEYSEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-504-0504
Mailing Address - Street 1:3636 UNIVERSITY BLVD S STE A8
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4210
Mailing Address - Country:US
Mailing Address - Phone:904-553-4900
Mailing Address - Fax:866-266-8160
Practice Address - Street 1:3636 UNIVERSITY BLVD S STE A8
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4210
Practice Address - Country:US
Practice Address - Phone:904-553-4900
Practice Address - Fax:866-266-8160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-23
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299994677251E00000X
261Q00000X, 261QH0100X, 261QM0801X, 261QM0850X, 261QM0855X, 261QM1300X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015596600Medicaid
FL109727900Medicaid
FL013829200Medicaid
FL013841200Medicaid