The Residence Retirement Center, Inc

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

AL5556 Issued in FL

Legal business name

THE RESIDENCE RETIREMENT CENTER, INC

Practice address

208 Marveline Dr
Lakeland, FL 33815-3447

Phone

(863) 687-7100

NPI assigned

Aug 27, 2014

Organization subpart

No

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

Authorized official

Name

Sara Richards

Title

Administrator

Phone

(863) 687-7100

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409097600000",
    "number": "1326448358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 MARVELINE DRIVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 MARVELINE DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338153447",
            "telephone_number": "863-687-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE RESIDENCE RETIREMENT CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-27",
        "last_updated": "2014-08-27",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "863-687-7100"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AL5556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140860700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Mental Illness) in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Assisted Living Facility (Mental Illness) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; 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.