2595 Harbor Blvd LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

2595 HARBOR BLVD LLC

Practice address

2595 Harbor Blvd
Port Charlotte, FL 33952-6732

Phone

(941) 769-9100

NPI assigned

Mar 8, 2022

Last updated

Nov 15, 2022By 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

Josh Rosen

Title

Manager

Phone

(469) 619-5372

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1646697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1124775242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5307 E MOCKINGBIRD LN STE 575",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752065109",
            "telephone_number": "469-619-5372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2595 HARBOR BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526732",
            "telephone_number": "941-769-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2595 HARBOR BLVD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-08",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "ROSEN",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "469-619-5372"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.