Rustic Retreat Florida LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

RUSTIC RETREAT FLORIDA LLC

Practice address

1120 N Federal Hwy
Boynton Beach, FL 33435-3229

Phone

(561) 737-5881

NPI assigned

Nov 23, 2022

Organization subpart

No

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

Authorized official

Name

Samuel Sufrin

Title

Member

Phone

(562) 517-0055

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669161600000",
    "number": "1386353886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 LONG BEACH BLVD STE 900",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073315",
            "telephone_number": "562-517-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 N FEDERAL HWY",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334353229",
            "telephone_number": "561-737-5881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSTIC RETREAT FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-23",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-22",
        "status": "A",
        "authorized_official_last_name": "SUFRIN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "562-517-0055"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Boynton Beach, FL
• Providers in Boynton Beach, 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 Nov 23, 2022; 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.