Southern Breeze Living, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

12111 Issued in FL

Legal business name

SOUTHERN BREEZE LIVING, LLC

Practice address

18 Woodward LN
Palm Coast, FL 32164-3103

Phone

(386) 447-7405

NPI assigned

Jan 6, 2014

Last updated

Jan 6, 2014By 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

Dennis Dean

Title

Administrator

Phone

(386) 447-7405

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1388966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388966400000",
    "number": "1457773780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 WOODWARD LN",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321643103",
            "telephone_number": "386-447-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 WOODWARD LN",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321643103",
            "telephone_number": "386-447-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN BREEZE LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-06",
        "last_updated": "2014-01-06",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "386-447-7405"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "12111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Palm Coast, FL
• Providers in Palm Coast, 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 Jan 6, 2014; 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.