NPIMap

Organization Active NPI

Retreat on Bywood

  • Assisted Living Facility
  • Port St Lucie, FL
National Provider Identifier
1265862080
Registry record updated Nov 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
12435 Issued in FL
Legal business name
RETREAT ON BYWOOD
Practice address
990 SE Bywood Ave
Port St Lucie, FL 34983-4065
Phone
(773) 333-2203
Fax
(772) 333-2203
NPI assigned
Nov 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2013

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

Authorized official

Name
Roovens Pierre Louis, LMT
Title
Administrator
Phone
(404) 707-0784

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 12435 FL Primary

Addresses

Primary practice location

990 SE Bywood Ave
Port St Lucie, FL 34983-4065

Mailing address

990 SE Bywood Ave
Port St Lucie, FL 34983-4065
Phone (773) 333-2203

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1384387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384387200000",
    "number": "1265862080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 SE BYWOOD AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349834065",
            "telephone_number": "773-333-2203",
            "fax_number": "772-333-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 SE BYWOOD AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349834065",
            "telephone_number": "773-333-2203",
            "fax_number": "772-333-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETREAT ON BYWOOD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-14",
        "last_updated": "2013-11-14",
        "status": "A",
        "authorized_official_last_name": "PIERRE LOUIS",
        "authorized_official_first_name": "ROOVENS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "404-707-0784",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "12435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.