Elderclub Port Richey Inc.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

ELDERCLUB PORT RICHEY INC.

Practice address

9735 US Highway 19
Port Richey, FL 34668-3846

Phone

(727) 484-7199

NPI assigned

Feb 2, 2024

Organization subpart

No

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

Authorized official

Name

Vivake Abraham

Title

Owner

Phone

(813) 406-0044

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707350400000",
    "number": "1124881180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 E ADAMO DR UNIT B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336055920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9735 US HIGHWAY 19",
            "city": "PORT RICHEY",
            "state": "FL",
            "postal_code": "346683846",
            "telephone_number": "727-484-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERCLUB PORT RICHEY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "VIVAKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-406-0044"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Day Care Clinic/Center in Port Richey, FL
• Providers in Port Richey, FL by specialty
• Adult Day Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; 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.