The Wilson Place

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL11786 Issued in FL

Legal business name

THE WILSON PLACE

Practice address

117 Wilson Ave
Cocoa Beach, FL 32931-3981

Phone

(321) 613-2867

Fax

(321) 396-7855

NPI assigned

Apr 24, 2012

Last updated

Apr 24, 2012By 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

Mr. Graham Duncan Lyle II

Title

Administator

Phone

(321) 613-2867

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335225600000",
    "number": "1205194545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 WILSON AVE",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329313981",
            "telephone_number": "321-613-2867",
            "fax_number": "321-396-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 WILSON AVE",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329313981",
            "telephone_number": "321-613-2867",
            "fax_number": "321-396-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WILSON PLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-24",
        "last_updated": "2012-04-24",
        "status": "A",
        "authorized_official_last_name": "LYLE",
        "authorized_official_first_name": "GRAHAM",
        "authorized_official_middle_name": "DUNCAN",
        "authorized_official_title_or_position": "ADMINISTATOR",
        "authorized_official_telephone_number": "321-613-2867",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL11786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Cocoa Beach, FL
• Providers in Cocoa 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 Apr 24, 2012; 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.