Good Samaritan Village LLLP

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

License

714547 Issued in FL

Legal business name

GOOD SAMARITAN VILLAGE LLLP

Practice address

26442 Whirlaway Ter
Wesley Chapel, FL 33544-1552

Phone

(860) 794-6457

NPI assigned

Aug 15, 2018

Organization subpart

No

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

Authorized official

Name

Derrick Appiah

Title

Member

Phone

(203) 558-4189

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Good Samaritan Village LLLP Former legal business name

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534291200000",
    "number": "1114407574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26442 WHIRLAWAY TER",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335441552",
            "telephone_number": "203-558-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26442 WHIRLAWAY TER",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335441552",
            "telephone_number": "860-794-6457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN VILLAGE LLLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-15",
        "last_updated": "2018-08-15",
        "status": "A",
        "authorized_official_last_name": "APPIAH",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "203-558-4189"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "FL",
            "license": "714547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "714547",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Samaritan Village LLLP",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Gabriella Gonzalez, BCBA
• Isaac Gonzalez, CRNA
• Katherine Gonzalez, APRN, FNP-BC
• Lisa Gonzalez, LMT
• Mayelin Gonzalez, APRN
• Maisie Gordon, M.S. CCC-SLP
• Ashley Gorniewicz
• Melissa Adela Gotcher, APRN, FNP-BC
• Tanika A Goulbourne
• Graceful Caring

• Developmental Disabilities Clinic/Center in Wesley Chapel, FL
• Providers in Wesley Chapel, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.