220 Golden LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

220 GOLDEN LLC

Practice address

220 9TH St
Port St Joe, FL 32456-1924

Phone

(954) 367-4597

Fax

(954) 367-4564

NPI assigned

Feb 7, 2017

Organization subpart

No

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

Authorized official

Name

Marline C Duroseau

Title

Cfo

Phone

(954) 367-4597

Specialties & licenses 1

Addresses

Other names 1

• Cross Shores Care Center Doing business as

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486425600000",
    "number": "1124566393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6511 NOVA DR STE 168",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333177401",
            "telephone_number": "954-367-4563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 9TH ST",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324561924",
            "telephone_number": "954-367-4597",
            "fax_number": "954-367-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "220 GOLDEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-07",
        "last_updated": "2017-02-07",
        "status": "A",
        "authorized_official_last_name": "DUROSEAU",
        "authorized_official_first_name": "MARLINE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "954-367-4597"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cross Shores Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Port St Joe, FL
• Providers in Port St Joe, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; 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.