SL Lake Howard Heights, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

5494 Issued in FL

Legal business name

SL LAKE HOWARD HEIGHTS, LLC

Practice address

650 N Lake Howard Dr
Winter Haven, FL 33881-3162

Phone

(863) 293-3171

Fax

(863) 299-3995

NPI assigned

May 21, 2007

Last updated

Aug 22, 2020By 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

Cynthia L. Hudgins

Title

Executive Director

Phone

(863) 293-3171

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356550198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 N LAKE HOWARD DR",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338813162",
            "telephone_number": "863-293-3171",
            "fax_number": "863-299-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 N LAKE HOWARD DR",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338813162",
            "telephone_number": "863-293-3171",
            "fax_number": "863-299-3995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SL LAKE HOWARD HEIGHTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUDGINS",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "863-293-3171"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "5494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PROVIDER ID NO",
            "identifier": "283701",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Smile Trust Dental Group Inc

• Assisted Living Facility in Winter Haven, FL
• Providers in Winter Haven, 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 Aug 22, 2020; 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.