Pvha/Sims - Gulf Breeze Courtyard, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL#9976 Issued in FL

Legal business name

PVHA/SIMS - GULF BREEZE COURTYARD, LLC

Practice address

3428 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-1400

Phone

(850) 934-1662

NPI assigned

Jul 20, 2007

Last updated

Jul 20, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Alan Daniel Parrish

Title

Manager

Phone

(904) 543-1818

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184889600000",
    "number": "1346440088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3428 GULF BREEZE PKWY",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325631400",
            "telephone_number": "850-934-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3428 GULF BREEZE PKWY",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325631400",
            "telephone_number": "850-934-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PVHA/SIMS - GULF BREEZE COURTYARD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2007-07-20",
        "status": "A",
        "authorized_official_last_name": "PARRISH",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "904-543-1818",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL#9976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Gulf Breeze, FL
• Providers in Gulf Breeze, 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 20, 2007; 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.