Imperial Livng Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

IMPERIAL LIVNG INC

Practice address

2820 39TH Ave N
St Petersburg, FL 33714-4524

Phone

(727) 657-5767

NPI assigned

Jan 30, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Nisa N Caraballo

Title

Coo

Phone

(727) 512-8465

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Imperial Livng Inc Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580342400000",
    "number": "1215568985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 39TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337144524",
            "telephone_number": "727-657-5767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 39TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337144524",
            "telephone_number": "727-657-5767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERIAL LIVNG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A",
        "authorized_official_last_name": "CARABALLO",
        "authorized_official_first_name": "NISA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "727-512-8465",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100285000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "IMPERIALLIVINGNC@GMAIL.COM",
            "affiliation": "N",
            "endpointDescription": "EMail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "2820 39th Ave N",
            "city": "St Petersburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337144524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Imperial Livng Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.