Bayside Adult Family Care Home, Inc

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

6906427 Issued in FL

Legal business name

BAYSIDE ADULT FAMILY CARE HOME, INC

Practice address

4314 Bayside Dr
Kissimmee, FL 34746-6054

Phone

(407) 396-1323

NPI assigned

Jan 11, 2011

Organization subpart

No

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

Authorized official

Name

Avis Worges

Title

Owner

Phone

(407) 396-1323

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1294704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1316242019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4314 BAYSIDE DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347466054",
            "telephone_number": "407-396-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4314 BAYSIDE DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347466054",
            "telephone_number": "407-396-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE ADULT FAMILY CARE HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-11",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "WORGES",
        "authorized_official_first_name": "AVIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-396-1323"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6906427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.