Easton'S Place LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12975 Issued in FL

Legal business name

EASTON'S PLACE LLC

Practice address

2301 W James Lee Blvd
Crestview, FL 32536-5409

Phone

(850) 306-2618

NPI assigned

Mar 22, 2017

Organization subpart

No

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

Authorized official

Name

Indiana Hein

Title

Administrator

Phone

(850) 603-5917

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492214400000",
    "number": "1083145072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 W JAMES LEE BLVD",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325365409",
            "telephone_number": "850-306-2618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 W JAMES LEE BLVD",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325365409",
            "telephone_number": "850-306-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTON'S PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-22",
        "last_updated": "2017-04-15",
        "status": "A",
        "authorized_official_last_name": "HEIN",
        "authorized_official_first_name": "INDIANA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "850-603-5917"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12975",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "FL",
            "license": "AL12975",
            "primary": false
        }
    ],
    "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 Apr 15, 2017; 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.