NPIMap

Organization Active NPI

Carolyn Clanton Alf LLC

  • Assisted Living Facility (Mental Illness)
  • Jennings, FL
National Provider Identifier
1003434028
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
Legal business name
CAROLYN CLANTON ALF LLC
Practice address
1146 Hamilton Ave
Jennings, FL 32053-2253
Phone
(386) 938-4102
NPI assigned
Jul 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Heather N Davis
Title
Administrator/Owner
Phone
(386) 855-1357

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Mental Illness) 3104A0625X Primary

Addresses

Primary practice location

1146 Hamilton Ave
Jennings, FL 32053-2253

Mailing address

1146 Hamilton Ave
Jennings, FL 32053-2253
Phone (229) 300-5469

Other names 1

  • Carolyn Clanton ALF LLC Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651104000000",
    "number": "1003434028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1146 HAMILTON AVE",
            "city": "JENNINGS",
            "state": "FL",
            "postal_code": "320532253",
            "telephone_number": "229-300-5469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1146 HAMILTON AVE",
            "city": "JENNINGS",
            "state": "FL",
            "postal_code": "320532253",
            "telephone_number": "386-938-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLYN CLANTON ALF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-07",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "386-855-1357",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolyn Clanton ALF LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carolyn Clanton ALF LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jennings, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.