FL Retirement I LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10528 Issued in FL

Legal business name

FL RETIREMENT I LLC

Doing business as

Hudson Manor

Practice address

115 E Davis Blvd
Tampa, FL 33606-3513

Phone

(813) 254-8399

Fax

(813) 254-6998

NPI assigned

Jun 3, 2008

Last updated

Jun 3, 2008By 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. David E Hauck

Title

Cfo

Phone

(717) 591-5703

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hudson Manor Doing business as

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1255590519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 LENA DRIVE SUITE 225",
            "address_2": "THE HOLLINGER GROUP",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "17055",
            "telephone_number": "717-591-5703",
            "fax_number": "717-591-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E DAVIS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063513",
            "telephone_number": "813-254-8399",
            "fax_number": "813-254-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FL RETIREMENT I LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-03",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "HAUCK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "717-591-5703",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "692467100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hudson Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Tampa, FL
• Providers in Tampa, 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 Jun 3, 2008; 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.