Ahc Southland-Melbourne, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

AHC SOUTHLAND-MELBOURNE, LLC

Practice address

2680 Croton Rd
Melbourne, FL 32935-3576

Phone

(321) 255-5443

NPI assigned

Dec 28, 2006

Organization subpart

Yes

Parent organization

BROOKDALE SENIOR LIVING INC.As reported in NPPES

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

Authorized official

Name

Bryan D Richardson

Title

Executive Vice President

Phone

(615) 221-2250

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brookdale Eau Gallie Doing business as

Part of

Brookdale Senior Living Inc

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462233600000",
    "number": "1154487825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6737 W WASHINGTON ST",
            "address_2": "SUITE 2300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532145647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 CROTON RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353576",
            "telephone_number": "321-255-5443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AHC SOUTHLAND-MELBOURNE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROOKDALE SENIOR LIVING INC.",
        "enumeration_date": "2006-12-28",
        "last_updated": "2016-05-03",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "615-221-2250"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "690889600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Eau Gallie",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaneez Z Agha, MD
• Dhiren Agrawal, DMD
• Jaymie Agsalud, MD
• Giselle Aguiar Barquie, APRN
• Paige Michelle Ahammer, ARNP
• Jennifer Jane Ahearn, MS
• Mohammed Mushtaq Ahmed
• Sonya Sayed Ahmed, MD
• Tamer S. Ahmed, M.D.
• Jennifer Ainsworth, RD

• All providers in Melbourne, FL
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; 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.