North Lake Retirement Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL7395 Issued in FL

Legal business name

NORTH LAKE RETIREMENT HOME

Practice address

1222 N 16TH Ave
Hollywood, FL 33020-3741

Phone

(954) 922-2643

NPI assigned

Jun 26, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Pascal Bergeron

Title

Asst Adm

Phone

(954) 922-2643

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191196800000",
    "number": "1417153446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 N 16TH AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330203741",
            "telephone_number": "954-922-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 N 16TH AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330203741",
            "telephone_number": "954-922-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH LAKE RETIREMENT HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2007-10-01",
        "status": "A",
        "authorized_official_last_name": "BERGERON",
        "authorized_official_first_name": "PASCAL",
        "authorized_official_title_or_position": "ASST ADM",
        "authorized_official_telephone_number": "954-922-2643",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL7395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Hollywood, FL
• Providers in Hollywood, 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 1, 2007; 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.