Blue Fountain Home Care, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL11411 Issued in FL

Legal business name

BLUE FOUNTAIN HOME CARE, LLC

Practice address

2440 Emerson Dr SE
Palm Bay, FL 32909-4972

Phone

(321) 327-8762

Fax

(321) 914-4069

NPI assigned

Nov 21, 2014

Last updated

Nov 21, 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

Magdad Delinois

Title

Administrator/Owner

Phone

(954) 559-3265

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416528000000",
    "number": "1073910840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 EMERSON DR SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329094972",
            "telephone_number": "321-327-8762",
            "fax_number": "321-914-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 EMERSON DR SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329094972",
            "telephone_number": "321-327-8762",
            "fax_number": "321-914-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE FOUNTAIN HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-21",
        "last_updated": "2014-11-21",
        "status": "A",
        "authorized_official_last_name": "DELINOIS",
        "authorized_official_first_name": "MAGDAD",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "954-559-3265"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL11411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Blanchard
• Nicole Blankman, ARNP
• Blendem Care LLC
• Jennifer Marie Bloodworth, FNP-BC
• Bloom at Oasis Therapy
• Blue Fountain I Home Care, LLC
• Blue Fountain II Home Care, LLC.
• Blue Fountain III Home Care, LLC
• Blue Fountain IV Home Care, LLC
• Blue Fountain V Home Care, LLC

• 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 Nov 21, 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.