Terrace of Daytona Beach LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1244096 Issued in FL

Legal business name

TERRACE OF DAYTONA BEACH LLC

Doing business as

terrace of daytona beach

Practice address

1704 Huntington Village Cir
Daytona Beach, FL 32114-1484

Phone

(386) 255-6571

Fax

(386) 255-1949

NPI assigned

Mar 17, 2006

Last updated

May 2, 2014By 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

Ms. Donna Marsh

Title

Cfo

Phone

(386) 244-1054

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• terrace of daytona beach Doing business as

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398988800000",
    "number": "1073582219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 HUNTINGTON VILLAGE CIR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141484",
            "telephone_number": "386-255-6571",
            "fax_number": "386-255-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 HUNTINGTON VILLAGE CIR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141484",
            "telephone_number": "386-255-6571",
            "fax_number": "386-255-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRACE OF DAYTONA BEACH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-17",
        "last_updated": "2014-05-02",
        "status": "A",
        "authorized_official_last_name": "MARSH",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "386-244-1054",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "1244096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021378400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "terrace of daytona beach",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; 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.