Active NPI
Enhanced Living Consultants Inc
- Home Modifications Contractor
- Coconut Creek, FL
National Provider Identifier
1205692696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Modifications Contractor
- Legal business name
- ENHANCED LIVING CONSULTANTS INC
- Practice address
- 4040 Edgewood Dr
Coconut Creek, FL 33066-1835 - Phone
- (954) 980-5002
- NPI assigned
- Feb 23, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Gipson
- Title
- President
- Phone
- (954) 980-5002
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | Primary |
Addresses
Primary practice location
4040 Edgewood Dr
Coconut Creek, FL 33066-1835
Mailing address
4040 Edgewood Dr
Coconut Creek, FL 33066-1835
Phone (954) 980-5002
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 113563300 | Medicaid | FL | |
| 114401600 | Medicaid | FL |
National Provider Directory
National Provider DirectoryPractitioners & 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.
-
- Developmentally Disabled Services Day Training Agency
- Coconut Creek, FL
- NPI 1558009449
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708646400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1708646400000",
"number": "1205692696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4040 EDGEWOOD DR",
"city": "COCONUT CREEK",
"state": "FL",
"postal_code": "330661835",
"telephone_number": "954-980-5002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4040 EDGEWOOD DR",
"city": "COCONUT CREEK",
"state": "FL",
"postal_code": "330661835",
"telephone_number": "954-980-5002"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ENHANCED LIVING CONSULTANTS INC",
"organizational_subpart": "NO",
"enumeration_date": "2024-02-23",
"last_updated": "2024-02-23",
"certification_date": "2024-02-23",
"status": "A",
"authorized_official_last_name": "GIPSON",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "954-980-5002"
},
"taxonomies": [
{
"code": "171WH0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Contractor, Home Modifications",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "113563300",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "114401600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Coconut Creek, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.