Organization Active NPI

Tender at Heart Assisted Living Facility Inc

  • Assisted Living Facility
  • Palm Bay, FL
National Provider Identifier
1194068221
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
12260 Issued in FL
Legal business name
TENDER AT HEART ASSISTED LIVING FACILITY INC
Practice address
1773 Hays St NW
Palm Bay, FL 32907-7115
Phone
(321) 327-2936
Fax
(321) 821-4626
NPI assigned
Mar 27, 2013
Last updated
Mar 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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

Authorized official

Name
Jenny-Ann Johnson
Title
Administrator
Phone
(321) 327-2936

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 12260 FL Primary

Addresses

Primary practice location

1773 Hays St NW
Palm Bay, FL 32907-7115

Mailing address

1773 Hays St NW
Palm Bay, FL 32907-7115
Phone (321) 327-2936

Other identifiers 1

IdentifierTypeStateIssuer
006637200MedicaidFL

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1194068221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1773 HAYS ST NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329077115",
            "telephone_number": "321-327-2936",
            "fax_number": "321-821-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1773 HAYS ST NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329077115",
            "telephone_number": "321-327-2936",
            "fax_number": "321-821-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENDER AT HEART ASSISTED LIVING FACILITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-27",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JENNY-ANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "321-327-2936"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "12260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006637200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.