Organization Active NPI

Naomi Janace Armistead

  • Adult Care Home Facility
  • Starke, FL
National Provider Identifier
1366782575
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
6906444 Issued in FL
Legal business name
NAOMI JANACE ARMISTEAD
Practice address
2876 SE 109TH St
Starke, FL 32091-7461
Phone
(352) 468-2435
Fax
(352) 468-2435
NPI assigned
Feb 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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

Authorized official

Name
Ms. Naomi Janace Armistead
Title
Owner
Phone
(352) 468-2435

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 6906444 FL Primary

Addresses

Primary practice location

2876 SE 109TH St
Starke, FL 32091-7461

Mailing address

2876 SE 109TH St
Starke, FL 32091-7461
Phone (352) 468-2435

Other names 1

  • Pine Forest Manor, LLC Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361750400000",
    "number": "1366782575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2876 SE 109TH ST",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320917461",
            "telephone_number": "352-468-2435",
            "fax_number": "352-468-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2876 SE 109TH ST",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320917461",
            "telephone_number": "352-468-2435",
            "fax_number": "352-468-2435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAOMI JANACE ARMISTEAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-25",
        "last_updated": "2013-02-25",
        "status": "A",
        "authorized_official_last_name": "ARMISTEAD",
        "authorized_official_first_name": "NAOMI",
        "authorized_official_middle_name": "JANACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-468-2435",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6906444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Forest Manor, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Starke, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.