Cloverdale Inn Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CLOVERDALE INN INC

Practice address

1114 W County Line Rd
Lutz, FL 33558-5032

Phone

(813) 949-8999

NPI assigned

Aug 20, 2025

Organization subpart

No

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

Authorized official

Name

Stephanie Wells, MEDICAL ASSISTANTNPI 1831511120

Title

Administrator

Phone

(813) 598-7628

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephanie Wells

  • Assisted Living Facility
  • Lutz, FL
  • NPI 1831511120
  NPD Authorized official

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

{
    "created_epoch": "1755648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755648000000",
    "number": "1508743584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 W COUNTY LINE RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335585032",
            "telephone_number": "813-949-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 W COUNTY LINE RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335585032",
            "telephone_number": "813-949-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVERDALE INN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-20",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "813-598-7628",
        "authorized_official_credential": "MEDICAL ASSISTANT"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chrystal G Clamp, MD
• Jennifer G Clark, MOT, OTR/L
• Michael Clauss
• Richard Clingo
• Phyllis Ann Cloman, LCSW
• Coast Florida P.a.
• Coast Surgical Group PLLC
• Coastal Souls Counseling LLC
• Maria de Lourdes De Lourdes Coats, APRN
• Jennifer Rebecca Coe, D.O.

• Assisted Living Facility in Lutz, FL
• Providers in Lutz, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; 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.