NPIMap

Organization Active NPI

The Christian & Missionary Alliance Foundation Inc

Doing business as Kings Crown-Shell Point Village

  • Assisted Living Facility
  • Fort Myers, FL
National Provider Identifier
1386073088
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL6012 Issued in FL
Legal business name
THE CHRISTIAN & MISSIONARY ALLIANCE FOUNDATION INC
Doing business as
Kings Crown-Shell Point Village
Practice address
3600 Kings Crown CT
Fort Myers, FL 33908-1648
Phone
(239) 454-2179
Fax
(239) 454-2221
NPI assigned
Nov 4, 2013
Last updated
Jan 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Authorized official

Name
Mrs. Rita Marie Southern
Title
Director of Assisted Living
Phone
(239) 454-2179

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL6012 FL Primary

Addresses

Primary practice location

3600 Kings Crown CT
Fort Myers, FL 33908-1648

Mailing address

15000 Shell Point Blvd
Fort Myers, FL 33908-1657
Phone (239) 454-2175

Other names 1

  • Kings Crown-Shell Point Village Doing business as

National Provider Directory

National Provider Directory
Tax ID family
The Christian Missionary a6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1386073088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15000 SHELL POINT BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339081657",
            "telephone_number": "239-454-2175",
            "fax_number": "239-454-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 KINGS CROWN CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339081648",
            "telephone_number": "239-454-2179",
            "fax_number": "239-454-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHRISTIAN & MISSIONARY ALLIANCE FOUNDATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-04",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "SOUTHERN",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR OF ASSISTED LIVING",
        "authorized_official_telephone_number": "239-454-2179",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL6012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kings Crown-Shell Point Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.