Tiffany Lake Care Centers, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

8788 Issued in FL

Legal business name

TIFFANY LAKE CARE CENTERS, INC

Practice address

402 N Riverside Dr
New Smyrna Beach, FL 32168-6740

Phone

(386) 423-1120

NPI assigned

Feb 20, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Desiree A Culver

Title

Owner/Administrator

Phone

(386) 689-2030

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1361318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361318400000",
    "number": "1225378730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 N RIVERSIDE DR",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321686740",
            "telephone_number": "386-423-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 N RIVERSIDE DR",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321686740",
            "telephone_number": "386-423-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFFANY LAKE CARE CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-20",
        "last_updated": "2013-02-20",
        "status": "A",
        "authorized_official_last_name": "CULVER",
        "authorized_official_first_name": "DESIREE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "386-689-2030",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "8788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dyran E Thomas
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• Rebecca June Thomas, PTA
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• Assisted Living Facility in New Smyrna Beach, FL
• Providers in New Smyrna 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, 2013; 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.