Nic 4 Emerald Park Retirement Leasing LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

9431 Issued in FL

Legal business name

NIC 4 EMERALD PARK RETIREMENT LEASING LLC

Practice address

5770 Stirling Rd.
Hollywood, FL 33021

Phone

(954) 987-5400

Fax

(954) 987-4942

NPI assigned

Apr 24, 2013

Organization subpart

No

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

Authorized official

Name

Jane Ryu

Title

President/Ceo/Cfo

Phone

(212) 479-5270

Specialties & licenses 1

Addresses

Other names 1

• Emerald Park Retirement Doing business as

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1154765857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1700 C/O HOLIDAY RETIREMENT",
            "address_2": "NIC 4 EMERALD PARK RETIREMENT LEASING LLC",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "97035",
            "telephone_number": "971-245-8020",
            "fax_number": "503-431-2295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 STIRLING RD.",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-987-5400",
            "fax_number": "954-987-4942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIC 4 EMERALD PARK RETIREMENT LEASING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-24",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "RYU",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "PRESIDENT/CEO/CFO",
        "authorized_official_telephone_number": "212-479-5270"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "9431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emerald Park Retirement",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Hollywood, FL
• Providers in Hollywood, 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 Dec 1, 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.