Naleenee Trader

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

AL10631 Issued in FL

Practice address

3091 NW 43Rd St
Lauderdale Lakes, FL 33309-4310

Phone

(954) 777-5167

Fax

(954) 733-1167

NPI assigned

Oct 28, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1414454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414454400000",
    "number": "1376948729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3091 NW 43RD ST",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333094310",
            "telephone_number": "954-777-5167",
            "fax_number": "954-733-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3091 NW 43RD ST",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333094310",
            "telephone_number": "954-777-5167",
            "fax_number": "954-733-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRADER",
        "first_name": "NALEENEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-28",
        "last_updated": "2014-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AL10631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140626400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Mental Illness) in Lauderdale Lakes, FL
• Providers in Lauderdale Lakes, FL by specialty
• Assisted Living Facility (Mental Illness) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.