New Dimension Family Care Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL13170 Issued in FL

Legal business name

NEW DIMENSION FAMILY CARE INC.

Practice address

849 SW Hamberland Ave
Port St Lucie, FL 34953-5629

Phone

(772) 359-2874

NPI assigned

Jul 20, 2018

Organization subpart

No

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

Authorized official

Name

Dwaine Hibbert

Title

Owner/Administrator

Phone

(954) 709-4866

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532044800000",
    "number": "1033696232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 SW HAMBERLAND AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349535629",
            "telephone_number": "772-359-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 SW HAMBERLAND AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349535629",
            "telephone_number": "772-359-2874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW DIMENSION FAMILY CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-20",
        "last_updated": "2018-07-20",
        "status": "A",
        "authorized_official_last_name": "HIBBERT",
        "authorized_official_first_name": "DWAINE",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "954-709-4866"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL13170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA",
            "identifier": "AL13170",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023957000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Port St Lucie, FL
• Providers in Port St Lucie, 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 20, 2018; 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.