Elders of Mount Dora LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12840 Issued in FL

Legal business name

ELDERS OF MOUNT DORA LLC

Doing business as

Ruth D. Peji

Practice address

6767 Round Lake Rd
Mount Dora, FL 32757-9636

Phone

(352) 434-7178

Fax

(407) 814-7514

NPI assigned

Nov 9, 2016

Organization subpart

No

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

Authorized official

Name

Ruth Danico Peji, ADMINISTRATOR

Title

Owner

Phone

(352) 434-7178

Specialties & licenses 1

Addresses

Other names 1

• RUTH D. PEJI Doing business as

Locations

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

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478649600000",
    "number": "1255873048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6767 ROUND LAKE RD",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327579636",
            "telephone_number": "352-434-7178",
            "fax_number": "407-814-7514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6767 ROUND LAKE RD",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327579636",
            "telephone_number": "352-434-7178",
            "fax_number": "407-814-7514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERS OF MOUNT DORA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-09",
        "last_updated": "2016-11-09",
        "status": "A",
        "authorized_official_last_name": "PEJI",
        "authorized_official_first_name": "RUTH",
        "authorized_official_middle_name": "DANICO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-434-7178",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RUTH D. PEJI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Mount Dora, FL
• Providers in Mount Dora, 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 Nov 9, 2016; 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.