1St Light of Hope

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

1ST LIGHT OF HOPE

Practice address

118 SW Andover CT
Port Saint Lucie, FL 34953-6961

Phone

(772) 214-5860

Fax

(800) 854-2598

NPI assigned

Feb 28, 2021

Last updated

Feb 28, 2021By 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

Mr. Don Durante Andrews

Title

Owner

Phone

(772) 214-5860

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• None Other name

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

{
    "created_epoch": "1614470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614470400000",
    "number": "1497349625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4451 SW DARLINGTON ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349537607",
            "telephone_number": "772-214-5860",
            "fax_number": "800-854-2598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 SW ANDOVER CT",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349536961",
            "telephone_number": "772-214-5860",
            "fax_number": "800-854-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1ST LIGHT OF HOPE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-28",
        "last_updated": "2021-02-28",
        "certification_date": "2021-02-28",
        "status": "A",
        "authorized_official_last_name": "ANDREWS",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "DURANTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-214-5860",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1262",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "None",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Developmental Disabilities Clinic/Center in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2021; 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.