NPIMap

Organization Active NPI

Yetey Enterprises Inc

  • Skilled Nursing Facility
  • Tampa, FL
National Provider Identifier
1063836781
Registry record updated Apr 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
YETEY ENTERPRISES INC
Doing business as
IMMANUEL AT YBOR ASSISTED LIVING FACILITY
YETEY ALF,SPRINGSWATER ALF AND IMMANUEL AT YBOR ALF
Practice address
3213 E 11TH Ave
Tampa, FL 33605
Phone
(813) 247-5852
NPI assigned
Feb 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2020

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

Authorized official

Name
Abiodun Adegbola
Title
Administrator
Phone
(813) 247-5852

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Mental Illness) 3104A0625X AL10756 FL
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3213 E 11TH Ave
Tampa, FL 33605

Mailing address

8602 N 22ND St
Tampa, FL 33604-2104
Phone (813) 930-8370

Other identifiers 1

IdentifierTypeStateIssuer
005550800MedicaidFL

Other names 2

  • IMMANUEL AT YBOR ASSISTED LIVING FACILITY Doing business as
  • YETEY ALF,SPRINGSWATER ALF AND IMMANUEL AT YBOR ALF Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Yetey Alfspringswater Alf and Immanuel at Ybor Alf3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1392595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587081600000",
    "number": "1063836781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8602 N 22ND ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336042104",
            "telephone_number": "813-930-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3213 E 11TH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33605",
            "telephone_number": "813-247-5852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YETEY ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-17",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A",
        "authorized_official_last_name": "ADEGBOLA",
        "authorized_official_first_name": "ABIODUN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "813-247-5852"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AL10756",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005550800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMMANUEL AT YBOR ASSISTED LIVING FACILITY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "YETEY ALF,SPRINGSWATER ALF AND IMMANUEL AT YBOR ALF",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; 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.