Summerville at Oviedo, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL9825 Issued in FL

Legal business name

SUMMERVILLE AT OVIEDO, LLC

Practice address

1725 Pine Bark Point
Oviedo, FL 32765

Phone

(407) 977-5250

Fax

(407) 977-7122

NPI assigned

Dec 8, 2009

Organization subpart

No

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

Authorized official

Name

Bryan Richardson

Title

Evp, Chief Admin. Officer

Phone

61556548131

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Brookdale Oviedo Doing business as

Tax ID family

Brookdale Oviedo2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Summerville Senior Living LLC

  • Assisted Living Facility
  • Oviedo, FL
  • NPI 1174733653
  NPD tax ID

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

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465776000000",
    "number": "1083943898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6737 W WASHINGTON ST STE 2300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532145650",
            "telephone_number": "414-918-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 PINE BARK POINT",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "32765",
            "telephone_number": "407-977-5250",
            "fax_number": "407-977-7122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERVILLE AT OVIEDO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-08",
        "last_updated": "2016-06-13",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "EVP, CHIEF ADMIN. OFFICER",
        "authorized_official_telephone_number": "61556548131"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL9525",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL9825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0089532-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Oviedo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Oviedo, FL
• Providers in Oviedo, 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 13, 2016; 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.