Broadmoor Alzheimer's & Memory Impairment Center of St Lucie County, I

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

BROADMOOR ALZHEIMER'S & MEMORY IMPAIRMENT CENTER OF ST LUCIE COUNTY, I

Practice address

200 Dixieland Dr
Fort Pierce, FL 34982-6706

Phone

(772) 489-6800

NPI assigned

Nov 8, 2006

Last updated

Aug 22, 2020By 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

Christopher Lundstrom

Title

President

Phone

(772) 489-6800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083784011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 N LAWNWOOD CIR",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504972",
            "telephone_number": "772-489-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DIXIELAND DR",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349826706",
            "telephone_number": "772-489-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADMOOR ALZHEIMER'S & MEMORY IMPAIRMENT CENTER OF ST LUCIE COUNTY, I",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUNDSTROM",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-489-6800"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lynn Brinkerhoff, MSW
• Melissa Brisard, RN
• Tracy Britcher-Speck, ARNP
• Brite Bridges of the Treasure Coast, Inc.
• Jose Carlos Brito Pita, RBT
• Broadmoor Operations, LLC
• Holly Ann Brolmann
• Karaya Brooks, RN, ARNP
• Latorrie Brooks, LPN
• Miranda Brooks, OTR/L

• Assisted Living Facility (Mental Illness) in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Assisted Living Facility (Mental Illness) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.