Lithia Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

13122 Issued in FL

Legal business name

LITHIA ASSISTED LIVING LLC

Practice address

13470 Boyette Rd
Riverview, FL 33569

Phone

(813) 278-5800

Fax

(813) 278-5906

NPI assigned

Aug 14, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Amy Van Kleeck

Title

Executive Director

Phone

(813) 278-5800

Specialties & licenses 1

Addresses

Other names 1

• Twin Creeks Assisted Living & Memory Care Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1376023945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13470 BOYETTE RD",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335695706",
            "telephone_number": "813-278-5800",
            "fax_number": "813-278-5906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13470 BOYETTE RD",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "33569",
            "telephone_number": "813-278-5800",
            "fax_number": "813-278-5906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITHIA ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-14",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "VAN KLEECK",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "813-278-5800",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "13122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Twin Creeks Assisted Living & Memory Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Riverview, FL
• Providers in Riverview, 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 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.