Senior Health TLTC, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL5898 Issued in FL

Legal business name

SENIOR HEALTH TLTC, LLC

Doing business as

Sunrise Village

Practice address

11722 N 17TH St
Tampa, FL 33612-5434

Phone

(813) 971-8072

Fax

(813) 972-9664

NPI assigned

Apr 9, 2013

Last updated

Apr 9, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Howard Jaffe

Title

President

Phone

(215) 346-6454

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sunrise Village Doing business as

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365465600000",
    "number": "1386087351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11722 N 17TH ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336125434",
            "telephone_number": "813-971-8072",
            "fax_number": "813-972-9664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11722 N 17TH ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336125434",
            "telephone_number": "813-971-8072",
            "fax_number": "813-972-9664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR HEALTH TLTC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-09",
        "last_updated": "2013-04-09",
        "status": "A",
        "authorized_official_last_name": "JAFFE",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-346-6454"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL5898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "687721400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Tampa, FL
• Providers in Tampa, 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 Apr 9, 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.