Ocamelot Dba Brooks Manor Alf

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL11748 Issued in FL

Legal business name

OCAMELOT DBA BROOKS MANOR ALF

Practice address

2043 SE Watercrest St
Port St Lucie, FL 34984-4768

Phone

(772) 878-2364

Fax

(772) 873-0200

NPI assigned

Sep 11, 2010

Last updated

Sep 11, 2010By 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

Mrs. Sabitri Persaud

Title

Administrator

Phone

(772) 878-2364

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1284163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284163200000",
    "number": "1427365402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2043 SE WATERCREST ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349844768",
            "telephone_number": "772-878-2364",
            "fax_number": "772-873-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 SE WATERCREST ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349844768",
            "telephone_number": "772-878-2364",
            "fax_number": "772-873-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCAMELOT DBA BROOKS MANOR ALF",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-11",
        "last_updated": "2010-09-11",
        "status": "A",
        "authorized_official_last_name": "PERSAUD",
        "authorized_official_first_name": "SABITRI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "772-878-2364",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL11748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002075100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Port St Lucie, FL
• Providers in Port St 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 Sep 11, 2010; 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.