Freedom Oaks Assisted Living, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

FREEDOM OAKS ASSISTED LIVING, INC.

Practice address

579 Johnson Lake Rd
De Leon Springs, FL 32130-3636

Phone

(386) 277-2010

Fax

(386) 277-2010

NPI assigned

Sep 12, 2020

Last updated

Sep 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Erica Hull

Title

Administrator

Phone

(386) 316-4633

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1599868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600732800000",
    "number": "1164037529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 JOHNSON LAKE RD",
            "city": "DE LEON SPRINGS",
            "state": "FL",
            "postal_code": "321303636",
            "telephone_number": "386-277-2010",
            "fax_number": "386-277-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 JOHNSON LAKE RD",
            "city": "DE LEON SPRINGS",
            "state": "FL",
            "postal_code": "321303636",
            "telephone_number": "386-277-2010",
            "fax_number": "386-277-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM OAKS ASSISTED LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-12",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A",
        "authorized_official_last_name": "HULL",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "386-316-4633"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106622400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorasaly Aguirre
• Karen Aytes-Rochester, COS, TCS
• Anel Beato Diaz
• Bloom Developmental Services LLC
• Laura Elaine Lore, MACCC-SLP
• John Richards McCormick, M.D.
• Michele McDonough
• Shawn Lee Peverly, LMHC
• Amy Lynn Rider

• Assisted Living Facility in De Leon Springs, FL
• Providers in De Leon Springs, 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 Sep 22, 2020; 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.