NPIMap

Organization Active NPI

Safe and Secure Respite Care, LLC

Doing business as Carington Manor

  • Alzheimer Center (Dementia Center)
  • Crestview, FL
National Provider Identifier
1023457306
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Alzheimer Center (Dementia Center)Taxonomy code 311500000X
License
AL11068 Issued in FL
Legal business name
SAFE AND SECURE RESPITE CARE, LLC
Doing business as
Carington Manor
Practice address
3215 E James Lee Blvd
Crestview, FL 32539-6037
Phone
(850) 423-1228
Fax
(850) 423-1231
NPI assigned
Jun 19, 2013
Last updated
Jun 19, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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

Authorized official

Name
Mrs. Sandra Anne Tingle, MSW, MA
Title
Administrator
Phone
(850) 423-1228

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Alzheimer Center (Dementia Center) 311500000X AL11068 FL Primary

Addresses

Primary practice location

3215 E James Lee Blvd
Crestview, FL 32539-6037

Mailing address

3215 E James Lee Blvd
Crestview, FL 32539-6037
Phone (850) 423-1228

Other identifiers 1

IdentifierTypeStateIssuer
001883200MedicaidFL

Other names 1

  • Carington Manor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Carington Manor2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371600000000",
    "number": "1023457306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3215 E JAMES LEE BLVD",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325396037",
            "telephone_number": "850-423-1228",
            "fax_number": "850-423-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 E JAMES LEE BLVD",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325396037",
            "telephone_number": "850-423-1228",
            "fax_number": "850-423-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE AND SECURE RESPITE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-19",
        "last_updated": "2013-06-19",
        "status": "A",
        "authorized_official_last_name": "TINGLE",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "850-423-1228",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW, MA"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "FL",
            "license": "AL11068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001883200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carington Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crestview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; 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.