The Ebenezer Alf II, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

THE EBENEZER ALF II, LLC

Practice address

304 Chaucer Ave
Lehigh Acres, FL 33936-7731

Phone

(239) 368-2101

NPI assigned

Dec 29, 2019

Organization subpart

No

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

Authorized official

Name

Yazmin Perez, RN

Title

Administrator

Phone

(239) 333-5920

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1577577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577577600000",
    "number": "1467091116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 CHAUCER AVE",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339367731",
            "telephone_number": "239-368-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 CHAUCER AVE",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339367731",
            "telephone_number": "239-368-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EBENEZER ALF II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-29",
        "last_updated": "2019-12-29",
        "certification_date": "2019-12-29",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "YAZMIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "239-333-5920",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylormedi Family Care Clinic
• Monica Telleria Yzquierdo
• Danilo Tellez Alarcon, RBT-23-317969
• Teresa A Thacker, ARNP
• The Anthurium
• The Ebenezer Alf, LLC
• The Good Samaritan, Inc.
• The Joan of Arc Corporation
• The Lighthouse Project, LLC
• The Medical Centre of Lehigh Acres Inc

• Assisted Living Facility in Lehigh Acres, FL
• Providers in Lehigh Acres, 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 Dec 29, 2019; 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.