Casual Country Living Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10167 Issued in FL

Legal business name

CASUAL COUNTRY LIVING INC.

Practice address

4801 Mango Ave
Cocoa, FL 32926-2921

Phone

(321) 632-9622

Fax

(321) 632-9622

NPI assigned

Apr 13, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Nancy Lee Dunleavy, CORE TRANING

Title

Owner Administrator

Phone

(321) 632-9622

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1334275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334275200000",
    "number": "1104183243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 MANGO AVE",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329262921",
            "telephone_number": "321-632-9622",
            "fax_number": "321-632-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 MANGO AVE",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329262921",
            "telephone_number": "321-632-9622",
            "fax_number": "321-632-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASUAL COUNTRY LIVING INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-13",
        "last_updated": "2012-04-13",
        "status": "A",
        "authorized_official_last_name": "DUNLEAVY",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER ADMINISTRATOR",
        "authorized_official_telephone_number": "321-632-9622",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CORE TRANING"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Care4Ucaregiversllc
• Careatc - City of Cocoa
• Carolina Care
• Michele Cassel
• Tanya Castillo
• Catrina Pauley, LMHC
• CCHC Inc
• Cecilia Land LCSW-R
• Ketsia Celestin Louis, M.D.
• Caroline R Cellich

• Assisted Living Facility in Cocoa, FL
• Providers in Cocoa, 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 Apr 13, 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.