Blue Fountain III Home Care, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BLUE FOUNTAIN III HOME CARE, LLC

Practice address

160 Maywood Ave NW
Palm Bay, FL 32907-2967

Phone

(321) 345-4353

NPI assigned

Apr 3, 2021

Last updated

Jun 10, 2024By 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

Magda Delinois

Title

Administrator/Owner

Phone

(954) 559-3265

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1617408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1023697430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 MAYWOOD AVE NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329072967",
            "telephone_number": "321-345-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 MAYWOOD AVE NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329072967",
            "telephone_number": "321-345-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE FOUNTAIN III HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-03",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "DELINOIS",
        "authorized_official_first_name": "MAGDA",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "954-559-3265"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.