NPIMap

Organization Active NPI

SL Mangrove, LLC

Doing business as Mangrove Bay

  • Assisted Living Facility
  • Jupiter, FL
National Provider Identifier
1366875544
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
10191 Issued in FL
Legal business name
SL MANGROVE, LLC
Doing business as
Mangrove Bay
Practice address
110 E Mangrove Bay Way
Jupiter, FL 33477-6401
Phone
(561) 575-3123
NPI assigned
Aug 12, 2013
Last updated
Aug 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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

Authorized official

Name
Ms. Kathy Wise
Title
Executive Director
Phone
(561) 575-4341

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 10191 FL Primary

Addresses

Primary practice location

110 E Mangrove Bay Way
Jupiter, FL 33477-6401

Mailing address

110 E Mangrove Bay Way
Jupiter, FL 33477-6401
Phone (561) 575-3123

Other names 1

  • Mangrove Bay 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": "1376265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376265600000",
    "number": "1366875544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E MANGROVE BAY WAY",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334776401",
            "telephone_number": "561-575-3123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E MANGROVE BAY WAY",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334776401",
            "telephone_number": "561-575-3123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SL MANGROVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-12",
        "last_updated": "2013-08-12",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "561-575-4341",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "10191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mangrove Bay",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.