The Iclt Summer Place Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

THE ICLT SUMMER PLACE INC

Doing business as

The ICLT Summer Place Inc

Practice address

350 Aladdin St
Opa Locka, FL 33054-3533

Phone

(305) 769-9438

NPI assigned

Feb 4, 2022

Organization subpart

No

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

Authorized official

Name

Laurel Notice

Title

Co- Director /President

Phone

(305) 778-9564

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The ICLT Summer Place Inc Doing business as

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643932800000",
    "number": "1144974627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 ALADDIN ST",
            "city": "OPA LOCKA",
            "state": "FL",
            "postal_code": "330543533",
            "telephone_number": "305-769-9438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 ALADDIN ST",
            "city": "OPA LOCKA",
            "state": "FL",
            "postal_code": "330543533",
            "telephone_number": "305-769-9438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ICLT SUMMER PLACE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-04",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A",
        "authorized_official_last_name": "NOTICE",
        "authorized_official_first_name": "LAUREL",
        "authorized_official_title_or_position": "CO- DIRECTOR /PRESIDENT",
        "authorized_official_telephone_number": "305-778-9564"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "686464396",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The ICLT Summer Place Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Opa Locka, FL
• Providers in Opa Locka, FL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.