Spirit Residential Group Home

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

SPIRIT RESIDENTIAL GROUP HOME

Doing business as

Spirit Residential Group Home

Practice address

17311 N.W 33 CT
Miami Gardens, FL 33056

Phone

(305) 623-4618

NPI assigned

Jun 8, 2017

Organization subpart

No

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

Authorized official

Name

Lola BainNPI 1144753641

Title

President

Phone

(305) 623-4618

Specialties & licenses 1

Addresses

Other names 1

• Spirit Residential Group Home Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lola Bain

  • Adult Care Home Facility
  • Miami Gardens, FL
  • NPI 1144753641
  NPD (past) Authorized official

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496880000000",
    "number": "1144759531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17311 NW 33RD CT",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330564218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17311 N.W 33 CT",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "33056",
            "telephone_number": "305-623-4618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPIRIT RESIDENTIAL GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-08",
        "last_updated": "2017-06-08",
        "status": "A",
        "authorized_official_last_name": "BAIN",
        "authorized_official_first_name": "LOLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-623-4618"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spirit Residential Group Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spirit Residential Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Miami Medical Center Inc
• Southern Universal Health Services LLC
• Spartakus Center Corp
• Andre Spencer
• Spetro and Associates Corp
• Ilya Spivak, DC
• Jacoy Nicole Springer
• SRS Homemaker and Companion Inc
• SSLD Group Corp
• SSM Behavioral Health Inc

• Developmental Disabilities Clinic/Center in Miami Gardens, FL
• Providers in Miami Gardens, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

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