Careola LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

CAREOLA LLC

Practice address

3248 Landing VW
Tavares, FL 32778-2035

Phone

(352) 250-2237

Fax

(352) 327-7030

NPI assigned

Aug 31, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Joshua Tyrone Peterkin Sr.

Title

Managing Director

Phone

(352) 250-2237

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598832000000",
    "number": "1497368203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3248 LANDING VW",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327782035",
            "telephone_number": "352-250-2237",
            "fax_number": "352-327-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3248 LANDING VW",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327782035",
            "telephone_number": "352-250-2237",
            "fax_number": "352-327-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAREOLA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-31",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A",
        "authorized_official_last_name": "PETERKIN",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "TYRONE",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "352-250-2237",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Tavares, FL
• Providers in Tavares, FL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.