Individual provider Active NPI

Marjorie Harrison

  • Assisted Living Facility (Mental Illness)
  • Arcadia, FL
National Provider Identifier
1487072476
Registry record updated Apr 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
License
AL10442 Issued in FL
Practice address
1289 SW Hillsborough Ave
Arcadia, FL 34266-8498
Phone
(863) 494-0099
NPI assigned
Apr 7, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Mental Illness) 3104A0625X 31104A0625X FL
Assisted Living Facility (Mental Illness) 3104A0625X AL10442 FL Primary

Addresses

Primary practice location

1289 SW Hillsborough Ave
Arcadia, FL 34266-8498

Mailing address

927 Bond St
Arcadia, FL 34266-3015
Phone (863) 494-0099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
31104A0625XFLMDAssisted Living Facility (Mental Illness)
AL10442FLMDAssisted Living Facility (Mental Illness)

NPI Registry JSON

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396828800000",
    "number": "1487072476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 BOND ST",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342663015",
            "telephone_number": "863-494-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1289 SW HILLSBOROUGH AVE",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342668498",
            "telephone_number": "863-494-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "MARJORIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-07",
        "last_updated": "2014-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "31104A0625X",
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AL10442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.