Organization Active NPI

Stonebridge Health Care

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Kissimmee, FL
National Provider Identifier
1114728540
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
STONEBRIDGE HEALTH CARE
Practice address
1045 Universal Rest PL
Kissimmee, FL 34744-5131
Phone
(646) 226-0864
NPI assigned
Mar 21, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Authorized official

Name
Hyungju Kim
Title
Admistrator
Phone
(646) 226-0864

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

1045 Universal Rest PL
Kissimmee, FL 34744-5131

Mailing address

1045 Universal Rest PL
Kissimmee, FL 34744-5131

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1742515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742515200000",
    "number": "1114728540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 UNIVERSAL REST PL",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347445131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 UNIVERSAL REST PL",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347445131",
            "telephone_number": "646-226-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONEBRIDGE HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-21",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "HYUNGJU",
        "authorized_official_title_or_position": "ADMISTRATOR",
        "authorized_official_telephone_number": "646-226-0864"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; 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.