NPIMap

Organization Active NPI

M&a Disable Veterans Assistant Living Home & Ministry, Inc

  • Pastoral Counselor
  • Port Saint Lucie, FL
National Provider Identifier
1497301303
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pastoral CounselorTaxonomy code 101YP1600X
Legal business name
M&A DISABLE VETERANS ASSISTANT LIVING HOME & MINISTRY, INC
Practice address
1850 SW Mackenzie St
Port Saint Lucie, FL 34953-1329
Phone
(772) 200-0436
Fax
(866) 270-2817
NPI assigned
Aug 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Authorized official

Name
Mr. Mark Anthony Anderson, CLERGY, CHAPLAIN
Title
Owner /Director
Phone
(772) 200-0436

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP1600X Primary

Addresses

Primary practice location

1850 SW Mackenzie St
Port Saint Lucie, FL 34953-1329

Mailing address

1850 SW Mackenzie St
Port Saint Lucie, FL 34953-1329
Phone (772) 200-0436

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565827200000",
    "number": "1497301303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 SW MACKENZIE ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349531329",
            "telephone_number": "772-200-0436",
            "fax_number": "866-270-2817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 SW MACKENZIE ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349531329",
            "telephone_number": "772-200-0436",
            "fax_number": "866-270-2817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M&A DISABLE VETERANS ASSISTANT LIVING HOME & MINISTRY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-15",
        "last_updated": "2019-08-15",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER /DIRECTOR",
        "authorized_official_telephone_number": "772-200-0436",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CLERGY, CHAPLAIN"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

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