433 Orange Drive, LLC

Key facts

NPI

1003159294

Entity type

Organization (NPI type 2)

Primary specialty

Assisted Living Facility 310400000X

License

AL7103 (FL)

Legal business name

433 ORANGE DRIVE, LLC

Practice address

433 Orange Dr
Altamonte Springs, FL 32701-5377

Phone

(407) 260-2433

NPI assigned

Apr 5, 2013

Organization subpart

No

Authorized official

Name

Dennis Forte

Title

Manager

Phone

(727) 726-3980

National Provider Directory

Specialties & licenses

Addresses

Other identifiers

Other names

• Grand Villa of Altamonte Springs Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 5, 2013.

{
    "created_epoch": "1365120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365120000000",
    "number": "1003159294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13770 58TH ST N STE 312",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337603759",
            "telephone_number": "727-726-3980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 ORANGE DR",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327015377",
            "telephone_number": "407-260-2433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "433 ORANGE DRIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-05",
        "last_updated": "2013-04-05",
        "status": "A",
        "authorized_official_last_name": "FORTE",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "727-726-3980"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL7103",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "FL",
            "license": "AL7103",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002973900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Villa of Altamonte Springs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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