NPIMap

Organization Active NPI

Safe and Secure Respite Care, LLC

  • Assisted Living Facility
  • Crestview, FL
National Provider Identifier
1124467345
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL9977 Issued in FL
Legal business name
SAFE AND SECURE RESPITE CARE, LLC
Practice address
3091 Skyline Dr
Crestview, FL 32539-8176
Phone
(850) 398-5207
Fax
(850) 398-8735
NPI assigned
Jun 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Authorized official

Name
Ms. Sandra Anne Tingle, MSW, MA
Title
Owner
Phone
(850) 398-5207

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL9977 FL Primary

Addresses

Primary practice location

3091 Skyline Dr
Crestview, FL 32539-8176

Mailing address

3091 Skyline Dr
Crestview, FL 32539-8176
Phone (850) 398-5207

Other identifiers 1

IdentifierTypeStateIssuer
109727800MedicaidFL

Other names 1

  • Carington Manor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Carington Manor2 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": "1371686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633651200000",
    "number": "1124467345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3091 SKYLINE DR",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325398176",
            "telephone_number": "850-398-5207",
            "fax_number": "850-398-8735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3091 SKYLINE DR",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325398176",
            "telephone_number": "850-398-5207",
            "fax_number": "850-398-8735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE AND SECURE RESPITE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-20",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A",
        "authorized_official_last_name": "TINGLE",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-398-5207",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW, MA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL9977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109727800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carington Manor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carington Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crestview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; 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.