Blue Fountain IV Home Care, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BLUE FOUNTAIN IV HOME CARE, LLC

Practice address

211 Silver Oak Rd NE
Palm Bay, FL 32907-5582

Phone

(954) 559-3265

Fax

(321) 914-4069

NPI assigned

Mar 27, 2024

Organization subpart

No

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

Authorized official

Name

Magda Delinois

Title

Owner

Phone

(954) 559-3265

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1295586303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 EMERSON DR SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329094972",
            "telephone_number": "954-559-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 SILVER OAK RD NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329075582",
            "telephone_number": "954-559-3265",
            "fax_number": "321-914-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE FOUNTAIN IV HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "DELINOIS",
        "authorized_official_first_name": "MAGDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-559-3265"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.