Good Shepherd Assisted Living Facility of Brandon LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL9000 Issued in FL

Legal business name

GOOD SHEPHERD ASSISTED LIVING FACILITY OF BRANDON LLC

Practice address

1801 Lido Drive
Brandon, FL 33511

Phone

(813) 684-4989

Fax

(813) 684-4989

NPI assigned

Apr 16, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Thelma Llanto Managad

Title

Administrator

Phone

(813) 494-2326

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334534400000",
    "number": "1013274091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 LIDO DRIVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "33511",
            "telephone_number": "813-684-4989",
            "fax_number": "813-684-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 LIDO DRIVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "33511",
            "telephone_number": "813-684-4989",
            "fax_number": "813-684-4989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SHEPHERD ASSISTED LIVING FACILITY OF BRANDON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-16",
        "last_updated": "2012-04-16",
        "status": "A",
        "authorized_official_last_name": "MANAGAD",
        "authorized_official_first_name": "THELMA",
        "authorized_official_middle_name": "LLANTO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "813-494-2326",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL9000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yasmin G Gonzalez
• Yezenia Gonzalez, M.S.W.
• Gonzalo Mosquera MD LLC
• Good Life at Home Care, LLC
• Good Shepherd Alf
• Tamisha Good, RN
• Mohammad Goodarzi, DMD
• Madison Goodman
• Ryan Goodrich, MOT, RBT
• Cassi Goodson

• Assisted Living Facility in Brandon, FL
• Providers in Brandon, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2012; 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.