NPIMap

Organization Active NPI

Polk County Board of County Commissioners

  • Alzheimer Center (Dementia Center)
  • Bartow, FL
National Provider Identifier
1396906707
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Alzheimer Center (Dementia Center)Taxonomy code 311500000X
License
390 Issued in FL
Legal business name
POLK COUNTY BOARD OF COUNTY COMMISSIONERS
Doing business as
CHARLES R. RICHARDSON ADULT DAY CARE CENTER
Practice address
615 N Jackson Ave
Bartow, FL 33830-3813
Phone
(863) 534-0393
NPI assigned
Jun 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Mr. Samuel (Sam) Johnson
Title
Chairman
Phone
(863) 534-6049

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Alzheimer Center (Dementia Center) 311500000X 390 FL Primary

Addresses

Primary practice location

615 N Jackson Ave
Bartow, FL 33830-3813

Mailing address

2135 Marshall Edwards Dr
Bartow, FL 33830-6757
Phone (863) 534-5659

Other names 1

  • CHARLES R. RICHARDSON ADULT DAY CARE CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Polk County Board of County10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

615 N Jackson Ave
Bartow, FL 33830
Phone (863) 534-0393

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1396906707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2135 MARSHALL EDWARDS DR",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338306757",
            "telephone_number": "863-534-5659",
            "fax_number": "863-534-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N JACKSON AVE",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338303813",
            "telephone_number": "863-534-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLK COUNTY BOARD OF COUNTY COMMISSIONERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SAMUEL (SAM)",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "863-534-6049",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "FL",
            "license": "390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHARLES R. RICHARDSON ADULT DAY CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bartow, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.