Forest Lane Healthcare LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

FOREST LANE HEALTHCARE LLC

Practice address

1616 Concierge Blvd Ste 103
Daytona Beach, FL 32117-7159

Phone

(386) 271-2753

NPI assigned

May 4, 2024

Organization subpart

No

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

Authorized official

Name

Damoya Davis

Title

Ceo

Phone

(904) 445-0261

Specialties & licenses 9

Addresses

Locations

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

{
    "created_epoch": "1714780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714780800000",
    "number": "1447007638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 FOREST LN",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141916",
            "telephone_number": "904-445-0261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 CONCIERGE BLVD STE 103",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177159",
            "telephone_number": "386-271-2753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST LANE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-04",
        "last_updated": "2024-05-04",
        "certification_date": "2024-05-04",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DAMOYA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-445-0261"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2024; 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.