Extended Family Alr Inc

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

AL12247 Issued in FL

Legal business name

EXTENDED FAMILY ALR INC

Practice address

1020 Claudia St
New Smyrna Beach, FL 32168-6354

Phone

(386) 957-3907

Fax

(386) 957-6316

NPI assigned

Feb 3, 2014

Last updated

Feb 3, 2014By 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. Matthew Hawkins Sr.

Title

President

Phone

(386) 957-3907

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1391385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391385600000",
    "number": "1356764823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 W LAKE DR",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327243245",
            "telephone_number": "386-957-3907",
            "fax_number": "386-957-6316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 CLAUDIA ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321686354",
            "telephone_number": "386-957-3907",
            "fax_number": "386-957-6316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED FAMILY ALR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-03",
        "last_updated": "2014-02-03",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-957-3907",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "FL",
            "license": "AL12247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Disabilities Residential Treatment Facility in New Smyrna Beach, FL
• Providers in New Smyrna Beach, FL by specialty
• Physical Disabilities Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.