Raw Fusion Living, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

RAW FUSION LIVING, LLC

Practice address

3837 Northdale Blvd
Suite 145
Tampa, FL 33624-1841

Phone

(813) 333-2626

NPI assigned

May 11, 2012

Organization subpart

No

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

Authorized official

Name

Lindajoy Rose

Title

President

Phone

(813) 333-2626

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336694400000",
    "number": "1497014302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3837 NORTHDALE BLVD",
            "address_2": "SUITE 145",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241841",
            "telephone_number": "813-333-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3837 NORTHDALE BLVD",
            "address_2": "SUITE 145",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241841",
            "telephone_number": "813-333-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAW FUSION LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-11",
        "last_updated": "2012-05-11",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "LINDAJOY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-333-2626"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2012; 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.