Bedrock at Home Orlando, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

BEDROCK AT HOME ORLANDO, LLC

Practice address

3800 Town Ctr Blvd
Orlando, FL 32837-6196

Phone

(407) 505-4602

Fax

(407) 505-4603

NPI assigned

Mar 6, 2024

Organization subpart

No

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

Authorized official

Name

Bailey Kleinknecht

Title

Business Operations Manager

Phone

(407) 505-4602

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1033976964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 TOWN CTR BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328376196",
            "telephone_number": "407-505-4602",
            "fax_number": "407-505-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 TOWN CTR BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328376196",
            "telephone_number": "407-505-4602",
            "fax_number": "407-505-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEDROCK AT HOME ORLANDO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "KLEINKNECHT",
        "authorized_official_first_name": "BAILEY",
        "authorized_official_title_or_position": "BUSINESS OPERATIONS MANAGER",
        "authorized_official_telephone_number": "407-505-4602"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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