The Promised Land Alf Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

THE PROMISED LAND ALF INC

Practice address

1041 NE Pine Island LN
Cape Coral, FL 33909-2176

Phone

(239) 288-8502

NPI assigned

Dec 21, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Alexis Matias, RN

Title

Owner

Phone

(239) 288-8502

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1545350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1194297606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 NE PINE ISLAND LN",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339092176",
            "telephone_number": "239-288-8502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 NE PINE ISLAND LN",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339092176",
            "telephone_number": "239-288-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PROMISED LAND ALF INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-21",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "MATIAS",
        "authorized_official_first_name": "ALEXIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-288-8502",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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