Organization Active NPI

Laurellwood Facility Inc

  • Skilled Nursing Facility
  • St Petersburg, FL
National Provider Identifier
1407355084
Registry record updated Feb 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LAURELLWOOD FACILITY INC
Practice address
3127 57TH Ave N
St Petersburg, FL 33714-1320
Phone
(727) 527-2171
NPI assigned
Feb 8, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2018

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

Authorized official

Name
Mr. Michael Bleich
Title
Authorized Representative
Phone
(845) 641-8314

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X FL Primary

Addresses

Primary practice location

3127 57TH Ave N
St Petersburg, FL 33714-1320

Mailing address

400 Rella Blvd Ste 200
Montebello, NY 10901-4239
Phone (845) 490-6060

Other names 1

  • Laurellwood Care Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518048000000",
    "number": "1407355084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RELLA BLVD STE 200",
            "city": "MONTEBELLO",
            "state": "NY",
            "postal_code": "109014239",
            "telephone_number": "845-490-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3127 57TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337141320",
            "telephone_number": "727-527-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURELLWOOD FACILITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-08",
        "last_updated": "2018-02-08",
        "status": "A",
        "authorized_official_last_name": "BLEICH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "845-641-8314",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laurellwood Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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.