Professional Retirement Home, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PROFESSIONAL RETIREMENT HOME, INC

Practice address

1900 SW 51St Ter
Plantation, FL 33317-5416

Phone

(954) 587-2198

Fax

(954) 533-3621

NPI assigned

Jul 16, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Daphne D Campbell, REGISTERED NURSE

Title

President/Ceo

Phone

(954) 587-2198

Specialties & licenses 1

Addresses

Other names 1

• Lehigh Assisted Living Facility Former legal business name

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1508020710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SW 51ST TER",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333175416",
            "telephone_number": "954-587-2198",
            "fax_number": "954-533-3621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SW 51ST TER",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333175416",
            "telephone_number": "954-587-2198",
            "fax_number": "954-533-3621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL RETIREMENT HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-16",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "DAPHNE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "954-587-2198",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "REGISTERED NURSE"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lehigh Assisted Living Facility",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.