Beachland Retirement Home

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

8841 Issued in FL

Legal business name

BEACHLAND RETIREMENT HOME

Practice address

462 Hernando St
Fort Pierce, FL 34949-3243

Phone

(772) 460-8007

Fax

(772) 460-8007

NPI assigned

Jun 6, 2013

Organization subpart

No

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

Authorized official

Name

Roman Grochowski

Title

Administrator/Owner

Phone

(772) 460-8007

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Beachland Retirement Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Beachland Retirement Home Inc.

  • Assisted Living Facility
  • Fort Pierce, FL
  • NPI 1245627918
  NPD tax ID

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370476800000",
    "number": "1376981985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 HERNANDO ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349493243",
            "telephone_number": "772-460-8007",
            "fax_number": "772-460-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 HERNANDO ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349493243",
            "telephone_number": "772-460-8007",
            "fax_number": "772-460-8007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACHLAND RETIREMENT HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-06",
        "last_updated": "2013-06-06",
        "status": "A",
        "authorized_official_last_name": "GROCHOWSKI",
        "authorized_official_first_name": "ROMAN",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "772-460-8007"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "8841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "675980700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Veronica Edith Bass, APRN
• Frances Ann Bates, RN
• Alejandro Jose Battistel, MD
• Erin Baughman
• Angeline Bazelais
• Beachland Retirement Home Inc.
• Beacon MD LLC
• Abigail Beard, DO
• Lisa Beatty
• Vennessa Kay-Ann Beaumont, PMHNP-BC

• Clinic/Center in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.