Senior Life LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SENIOR LIFE LLC

Practice address

619 Orange Ave
Daytona Beach, FL 32114-4786

Phone

(813) 319-0961

NPI assigned

Feb 20, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Charles W Cherry II, J.D., M.B.A.

Title

Senior Administrator

Phone

(813) 267-7342

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392854400000",
    "number": "1194140509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48857",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336460124",
            "telephone_number": "813-319-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 ORANGE AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144786",
            "telephone_number": "813-319-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-20",
        "last_updated": "2014-02-20",
        "status": "A",
        "authorized_official_last_name": "CHERRY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "SENIOR ADMINISTRATOR",
        "authorized_official_telephone_number": "813-267-7342",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "J.D., M.B.A."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Daytona Beach, FL
• Providers in Daytona Beach, 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 Feb 20, 2014; 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.