Traumatic Brain Education Adult Community Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL0008514 Issued in FL

Legal business name

TRAUMATIC BRAIN EDUCATION ADULT COMMUNITY HOME

Practice address

3858 W Main St
Wauchula, FL 33873-9395

Phone

(863) 773-2857

Fax

(863) 773-2041

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Jason Travis Bone

Title

Administrator

Phone

(863) 773-2857

Specialties & licenses 1

Addresses

Other names 1

• TEACH, Inc. Doing business as

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114052933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1722",
            "city": "WAUCHULA",
            "state": "FL",
            "postal_code": "338731722",
            "telephone_number": "863-773-2857",
            "fax_number": "863-773-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3858 W MAIN ST",
            "city": "WAUCHULA",
            "state": "FL",
            "postal_code": "338739395",
            "telephone_number": "863-773-2857",
            "fax_number": "863-773-2041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAUMATIC BRAIN EDUCATION ADULT COMMUNITY HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BONE",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "TRAVIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "863-773-2857",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL0008514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TEACH, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tampa Bay Emergency Physicians-Heartland LLC
• Gurkan F Taviloglu, M.D.
• TDN Dentistry, PLLC
• Franz Banta Timbol, MSN, FNP-C
• Clifton N Timmerman, O.D.
• Maria Trujillo, AP
• Sonia Vargas Suarez
• Jennifer Villarete, AGNP
• Maria Villeda
• Mary E Vonmerveldt, ARNP

• Assisted Living Facility in Wauchula, FL
• Providers in Wauchula, 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 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.