Indian Rocks Assisted Living, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10811 Issued in FL

Legal business name

INDIAN ROCKS ASSISTED LIVING, INC.

Practice address

2050 E Bay Dr
Largo, FL 33771-2321

Phone

(727) 559-7666

NPI assigned

Jan 22, 2014

Organization subpart

No

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

Authorized official

Name

Dave Gery

Title

Administrator

Phone

(727) 599-7644

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heron House Indian Rocks Doing business as

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

{
    "created_epoch": "1390348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390348800000",
    "number": "1366865784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 E BAY DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337712321",
            "telephone_number": "727-559-7666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 E BAY DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337712321",
            "telephone_number": "727-559-7666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN ROCKS ASSISTED LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-22",
        "last_updated": "2014-01-22",
        "status": "A",
        "authorized_official_last_name": "GERY",
        "authorized_official_first_name": "DAVE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "727-599-7644"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142595100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heron House Indian Rocks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mona Ido, L.M.H.C.
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• Indian Rocks Medical Center Inc
• Individual & Family Services Inc
• Leann Sarah Infante, BCBA
• Jeffrey Broughton Ingalls, D.M.D.

• Assisted Living Facility in Largo, FL
• Providers in Largo, 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 Jan 22, 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.