Autumn Breeze Assisted Living Facility Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL11309 Issued in FL

Legal business name

AUTUMN BREEZE ASSISTED LIVING FACILITY INC

Practice address

904 Lake Martha Dr NE
Winter Haven, FL 33881-4278

Phone

(863) 292-0780

Fax

(863) 291-0808

NPI assigned

Jul 7, 2014

Last updated

Jul 7, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marie Possible

Title

Owner

Phone

(863) 242-5544

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404691200000",
    "number": "1023424405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 LAKE MARTHA DR NE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814278",
            "telephone_number": "863-292-0780",
            "fax_number": "863-291-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 LAKE MARTHA DR NE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814278",
            "telephone_number": "863-292-0780",
            "fax_number": "863-291-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTUMN BREEZE ASSISTED LIVING FACILITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-07",
        "last_updated": "2014-07-07",
        "status": "A",
        "authorized_official_last_name": "POSSIBLE",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-242-5544"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL11309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Winter Haven, FL
• Providers in Winter Haven, 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 Jul 7, 2014; 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.