Summers Landing LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SUMMERS LANDING LLC

Practice address

615 Florida Ave
Lynn Haven, FL 32444-1737

Phone

(904) 881-3773

NPI assigned

Dec 28, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Brendan J Delamielleure Jr.

Title

Cfo

Phone

(904) 881-3773

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SUMMERS LANDING ASSISTED LIVING Doing business as

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

{
    "created_epoch": "1545955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547510400000",
    "number": "1477025609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 FLORIDA AVE",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324441737",
            "telephone_number": "904-881-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 FLORIDA AVE",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324441737",
            "telephone_number": "904-881-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERS LANDING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-28",
        "last_updated": "2019-01-15",
        "status": "A",
        "authorized_official_last_name": "DELAMIELLEURE",
        "authorized_official_first_name": "BRENDAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "904-881-3773",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101318000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUMMERS LANDING ASSISTED LIVING",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SUMMERS LANDING ASSISTED LIVING",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Lynn Haven, FL
• Providers in Lynn Haven, 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 15, 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.