NPIMap

Organization Active NPI

Loving Angels Assisted Living, Inc.

  • Assisted Living Facility
  • Palm Coast, FL
National Provider Identifier
1114478948
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL12405 Issued in FL
Legal business name
LOVING ANGELS ASSISTED LIVING, INC.
Practice address
9 Ramble Way
Palm Coast, FL 32164-8800
Phone
(917) 582-2393
NPI assigned
Oct 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Authorized official

Name
Miss Teresa Gomez
Title
Administrator/Owner
Phone
(917) 582-2393

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL12405 FL Primary

Addresses

Primary practice location

9 Ramble Way
Palm Coast, FL 32164-8800

Mailing address

77B Brunswick LN
Palm Coast, FL 32137-3627
Phone (917) 582-2393

Other identifiers 1

IdentifierTypeStateIssuer
010584200MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Loving Angels Assisted Living Facilitiesinc2 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.

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476662400000",
    "number": "1114478948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77B BRUNSWICK LN",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373627",
            "telephone_number": "917-582-2393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 RAMBLE WAY",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321648800",
            "telephone_number": "917-582-2393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOVING ANGELS ASSISTED LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "917-582-2393",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010584200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.