Midway Manor Alf Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL8632 Issued in FL

Legal business name

MIDWAY MANOR ALF INC

Practice address

1754 Ensley Ave
Clearwater, FL 33756-7221

Phone

(727) 526-1969

NPI assigned

Jul 31, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Bobbie Diehl

Title

Administrator

Phone

(727) 586-1969

Specialties & licenses 1

Addresses

Other names 1

• Midway Manor Retirement Residence Other name

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1295167336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1754 ENSLEY AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337567221",
            "telephone_number": "727-526-1969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1754 ENSLEY AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337567221",
            "telephone_number": "727-526-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWAY MANOR ALF INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-31",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "DIEHL",
        "authorized_official_first_name": "BOBBIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "727-586-1969",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL8632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midway Manor Retirement Residence",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Assisted Living Facility in Clearwater, FL
• Providers in Clearwater, 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 Jul 31, 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.