Soaring Eagle Investment/Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12052 Issued in FL

Legal business name

SOARING EAGLE INVESTMENT/ASSISTED LIVING

Practice address

1568 SW California Blvd.
Port St. Lucie, FL 34953

Phone

(772) 249-4745

Fax

(772) 607-5157

NPI assigned

May 6, 2013

Last updated

May 6, 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

Doreen K Lawrence

Title

Owner/Administrator

Phone

(772) 249-4745

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367798400000",
    "number": "1467897363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1568 SW CALIFORNIA BLVD.",
            "city": "PORT ST. LUCIE",
            "state": "FL",
            "postal_code": "34953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1568 SW CALIFORNIA BLVD.",
            "city": "PORT ST. LUCIE",
            "state": "FL",
            "postal_code": "34953",
            "telephone_number": "772-249-4745",
            "fax_number": "772-607-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOARING EAGLE INVESTMENT/ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-06",
        "last_updated": "2013-05-06",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "DOREEN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "772-249-4745"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Port St Lucie, FL
• Providers in Port St Lucie, 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 May 6, 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.