Emerald Garden, Inc.

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

AL9997 Issued in FL

Legal business name

EMERALD GARDEN, INC.

Practice address

2159 N McMullen Booth Rd
Clearwater, FL 33759-1418

Phone

(727) 669-5014

NPI assigned

Sep 12, 2010

Last updated

Sep 12, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kamran Rouhani, ALF LICENSE

Title

Administrator

Phone

(727) 669-5014

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1284249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284249600000",
    "number": "1124335112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2159 N MCMULLEN BOOTH RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337591418",
            "telephone_number": "727-669-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2159 N MCMULLEN BOOTH RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337591418",
            "telephone_number": "727-669-5014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD GARDEN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-12",
        "last_updated": "2010-09-12",
        "status": "A",
        "authorized_official_last_name": "ROUHANI",
        "authorized_official_first_name": "KAMRAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "727-669-5014",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ALF LICENSE"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AL9997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA, ASSISTED LIVING FACILITY",
            "identifier": "AL9997",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Mental Illness) in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Assisted Living Facility (Mental Illness) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.