Country Living Assisted Care Center Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL11331 Issued in FL

Legal business name

COUNTRY LIVING ASSISTED CARE CENTER INC

Practice address

1762 SW Arch St
Port Saint Lucie, FL 34953-1558

Phone

(772) 621-8211

Fax

(772) 621-8211

NPI assigned

Feb 9, 2008

Organization subpart

No

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

Authorized official

Name

Carol Ann Cammarsana

Title

Adm

Phone

(772) 626-1150

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1202515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225411200000",
    "number": "1417135682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1762 SW ARCH ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349531558",
            "telephone_number": "772-621-8211",
            "fax_number": "772-621-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1762 SW ARCH ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349531558",
            "telephone_number": "772-621-8211",
            "fax_number": "772-621-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY LIVING ASSISTED CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-09",
        "last_updated": "2008-10-31",
        "status": "A",
        "authorized_official_last_name": "CAMMARSANA",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADM",
        "authorized_official_telephone_number": "772-626-1150"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL11331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDWAIVER",
            "identifier": "692697596",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Cortez
• Anika Costa, BCBA
• Claudia Liliana Costa, APRN
• Council on Aging of St. Lucie Inc.
• Counseling Through Hope, LLC
• Nancy Cox, PHD/DNM, MSED, RA-C
• Patricia Cox, DC
• Delilah Cranmer, MS, LBS, BCBA
• Creative Swim Therapy
• Christina Cremeans

• Assisted Living Facility in Port Saint Lucie, FL
• Providers in Port Saint Lucie, 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 Oct 31, 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.