Madison American Bonita Springs TRS I, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MADISON AMERICAN BONITA SPRINGS TRS I, LLC

Practice address

11400 Longfellow LN
Bonita Springs, FL 34135-5963

Phone

(239) 301-4239

Fax

(239) 301-0613

NPI assigned

Nov 17, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Sheila Darga

Title

VP Corporate Licensing

Phone

(248) 203-1800

Specialties & licenses 1

Addresses

Other names 1

• American House Bonita Doing business as

Locations

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637107200000",
    "number": "1174280846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TOWNE SQ STE 1600",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763728",
            "telephone_number": "248-203-1800",
            "fax_number": "248-203-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11400 LONGFELLOW LN",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341355963",
            "telephone_number": "239-301-4239",
            "fax_number": "239-301-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON AMERICAN BONITA SPRINGS TRS I, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A",
        "authorized_official_last_name": "DARGA",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "VP CORPORATE LICENSING",
        "authorized_official_telephone_number": "248-203-1800",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American House Bonita",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Bonita Springs, FL
• Providers in Bonita 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 Nov 17, 2021; 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.