Spoli Corp

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

SPOLI CORP

Practice address

1157 John Anderson Dr
Ormond Beach, FL 32176-4173

Phone

(386) 441-6045

NPI assigned

Feb 7, 2022

Organization subpart

Yes

Parent organization

BETHESDA MANORAs reported in NPPES

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

Authorized official

Name

Pam Oli

Title

Owner

Phone

(386) 451-1245

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bethesda Manor Doing business as

Part of

Spoli Corp

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644192000000",
    "number": "1144974403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 JOHN ANDERSON DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321764173",
            "telephone_number": "386-441-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157 JOHN ANDERSON DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321764173",
            "telephone_number": "386-441-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPOLI CORP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BETHESDA MANOR",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A",
        "authorized_official_last_name": "OLI",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-451-1245"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "676245096",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bethesda Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Developmentally Disabled Services Day Training Agency in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Developmentally Disabled Services Day Training Agency in Florida

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