Rebecca Assisted Living Facility

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

REBECCA ASSISTED LIVING FACILITY

Practice address

2015 Derbywood Dr
Brandon, FL 33510-2213

Phone

(813) 629-3428

Fax

(813) 438-8555

NPI assigned

Sep 17, 2021

Organization subpart

No

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

Authorized official

Name

Macaulay O Igbinosun

Title

Ceo

Phone

(813) 629-3428

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1631836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631836800000",
    "number": "1104596485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 DERBYWOOD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335102213",
            "telephone_number": "813-629-3428",
            "fax_number": "813-438-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 DERBYWOOD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335102213",
            "telephone_number": "813-629-3428",
            "fax_number": "813-438-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBECCA ASSISTED LIVING FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-17",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A",
        "authorized_official_last_name": "IGBINOSUN",
        "authorized_official_first_name": "MACAULAY",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "813-629-3428"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Brandon, FL
• Providers in Brandon, 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 Sep 17, 2021; 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.