Green Acres

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

AI8642 Issued in FL

Legal business name

GREEN ACRES

Practice address

15820 Archer St
Hudson, FL 34667-3816

Phone

(727) 861-2975

Fax

(727) 857-4533

NPI assigned

Jul 16, 2014

Last updated

Jan 20, 2017By 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

Luz T Kalbarczyk

Title

Owner/Adminstrator

Phone

(727) 861-2975

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484870400000",
    "number": "1396152963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15820 ARCHER ST",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346673816",
            "telephone_number": "727-861-2975",
            "fax_number": "727-857-4533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15820 ARCHER ST",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346673816",
            "telephone_number": "727-861-2975",
            "fax_number": "727-857-4533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN ACRES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-16",
        "last_updated": "2017-01-20",
        "status": "A",
        "authorized_official_last_name": "KALBARCZYK",
        "authorized_official_first_name": "LUZ",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER/ADMINSTRATOR",
        "authorized_official_telephone_number": "727-861-2975"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AI8642",
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AI8642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140906900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Muna Goyal, M.D
• Rajiva Goyal, M.D.
• Savannah L Grandy
• Stephanie Grant, MD
• Troi Graves, DO STUDENT
• Agnes P Green, M.D.
• Jane Griggs
• Scott D Grimm, PAC
• Qin Gu
• Christina Guida, ATC, LAT

• Assisted Living Facility (Mental Illness) in Hudson, FL
• Providers in Hudson, 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 Jan 20, 2017; 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.