Angel's Retreat Assisted Living Facility

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12017 Issued in FL

Legal business name

ANGEL'S RETREAT ASSISTED LIVING FACILITY

Practice address

224 Godfrey Rd SE
Palm Bay, FL 32909-8816

Phone

(321) 549-9136

NPI assigned

Jun 14, 2012

Last updated

Jun 14, 2012By 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

Virginia Weaks

Title

Owner

Phone

(321) 549-9136

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339632000000",
    "number": "1073875001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 GODFREY RD SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329098816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 GODFREY RD SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329098816",
            "telephone_number": "321-549-9136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL'S RETREAT ASSISTED LIVING FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-14",
        "last_updated": "2012-06-14",
        "status": "A",
        "authorized_official_last_name": "WEAKS",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-549-9136"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Jean Amelunge, PSR
• Amicus Physician Services, Inc.
• Atm N Amin, BDS
• Anchor FL Opco LLC (Anchor Care & Rehabilitation Center)
• Angel's Care Sevices US LLC
• Angela S. Spencer M.D, PA
• Angels for Kids on Call 24/7 Inc.
• Angels for Kids on Call 24/7 Inc.
• Angels Landing of Brevard Inc
• Angelsonyourshoulder

• Assisted Living Facility in Palm Bay, FL
• Providers in Palm Bay, 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 Jun 14, 2012; 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.