Stillwater Alf Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10861 Issued in FL

Legal business name

STILLWATER ALF INC.

Practice address

2881 Quentin Ave SE
Palm Bay, FL 32909-9225

Phone

(321) 914-3688

Fax

(321) 914-3689

NPI assigned

Mar 27, 2013

Last updated

Mar 27, 2013By 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

Rudolph L Lewis Sr.

Title

Administrator

Phone

(321) 684-3691

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1437492519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2881 QUENTIN AVE SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329099225",
            "telephone_number": "321-914-3688",
            "fax_number": "321-914-3689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2881 QUENTIN AVE SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329099225",
            "telephone_number": "321-914-3688",
            "fax_number": "321-914-3689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILLWATER ALF INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-27",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "RUDOLPH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "321-684-3691",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnathon Kevin Stevens, LMT
• Dawn Ann Stewart-Brown, DNP
• Donna Stewart
• Grace Noel Stewart
• Kurtisha Stewart
• Stilwater Alf Brickell Inc.
• Edward C Stocker, PHARMD.
• Sheena A Stone
• Amanda Streb
• Donna Strickland

• Assisted Living Facility in Palm Bay, FL
• Providers in Palm Bay, 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 Mar 27, 2013; 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.