Hsre-Ahr Bonita Springs TRS LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12672 Issued in FL

Legal business name

HSRE-AHR BONITA SPRINGS TRS LLC

Doing business as

American House Bonita Springs

Practice address

11400 Longfellow LN
Bonita Springs, FL 34135-5963

Phone

(239) 301-4239

Fax

(239) 301-0613

NPI assigned

Feb 19, 2018

Organization subpart

No

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

Authorized official

Name

Eugene Valentine

Title

Administrator

Phone

(239) 301-4239

Specialties & licenses 1

Addresses

Other names 1

• American House Bonita Springs Doing business as

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637107200000",
    "number": "1437659232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11400 LONGFELLOW LN",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341355963",
            "telephone_number": "239-301-4239",
            "fax_number": "239-301-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11400 LONGFELLOW LN",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341355963",
            "telephone_number": "239-301-4239",
            "fax_number": "239-301-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HSRE-AHR BONITA SPRINGS TRS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-19",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A",
        "authorized_official_last_name": "VALENTINE",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "239-301-4239"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American House Bonita Springs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Bonita Springs, FL
• Providers in Bonita Springs, 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 Nov 17, 2021; 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.