Integrity - Dixie Oak Manor, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL8502 Issued in FL

Legal business name

INTEGRITY - DIXIE OAK MANOR, LLC

Practice address

6410 Old Dixie Hwy
Vero Beach, FL 32967-5909

Phone

(772) 569-7777

NPI assigned

Sep 12, 2017

Organization subpart

No

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

Authorized official

Name

Jonathan Swain Short

Title

Cio

Phone

(336) 438-1383

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637193600000",
    "number": "1144749037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 KOGER BLVD STE 150",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274072738",
            "telephone_number": "336-438-1376",
            "fax_number": "336-438-1387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 OLD DIXIE HWY",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329675909",
            "telephone_number": "772-569-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRITY - DIXIE OAK MANOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-12",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A",
        "authorized_official_last_name": "SHORT",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "SWAIN",
        "authorized_official_title_or_position": "CIO",
        "authorized_official_telephone_number": "336-438-1383"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL8502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Innovative Rehab and Wellness Inc
• Insight Psychiatry and Wellness
• Integrated Medical Therapy Group LLC
• Integrated Regional Laboratories Pathology Services, LLC
• Integrated Rehabilitation Adult and Pediatrics LLC
• Intergold LLC
• Intermedik LLC
• Interventional Pain Management of the Treasure Coast PA
• Interventional Spine and Pain Institute LLC
• Genevieve Theresa Introcaso, LCSW

• Assisted Living Facility in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.