Active NPI
Selah-Gulf Breeze Courtyard, LLC
Doing business as Gulf Breeze Courtyard
- Assisted Living Facility
- Gulf Breeze, FL
National Provider Identifier
1538594577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- AL9976
- Legal business name
- SELAH-GULF BREEZE COURTYARD, LLC
- Doing business as
- Gulf Breeze Courtyard
- Practice address
- 3428 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-1400 - Phone
- (850) 934-1662
- Fax
- (850) 934-4218
- NPI assigned
- Sep 10, 2013
- Organization subpart
- Yes
- Parent organization
- SELAH SENIORCARE II, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Alan Daniel Parrish
- Title
- Manager
- Phone
- (904) 543-1818
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | AL9976 | FL | Primary |
Addresses
Primary practice location
3428 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-1400
Mailing address
3428 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-1400
Phone (850) 934-1662
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7618 | Other | FL | WORLDNET - MEDICAID DIVERSION PROGRAM |
| 003102500 | Other | FL | MEDICAID WAIVER PROGRAM |
| 109168 | Other | FL | AMERICAN ELDERCARE - MEDICAID DIVERSION PROGRAM |
Other names 1
- Gulf Breeze Courtyard
National Provider Directory
National Provider Directory- Part of
- Sela Cedar Creek LLC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378771200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1378771200000",
"number": "1538594577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3428 GULF BREEZE PKWY",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "325631400",
"telephone_number": "850-934-1662",
"fax_number": "850-934-4218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3428 GULF BREEZE PKWY",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "325631400",
"telephone_number": "850-934-1662",
"fax_number": "850-934-4218"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SELAH-GULF BREEZE COURTYARD, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SELAH SENIORCARE II, LLC",
"enumeration_date": "2013-09-10",
"last_updated": "2013-09-10",
"status": "A",
"authorized_official_last_name": "PARRISH",
"authorized_official_first_name": "ALAN",
"authorized_official_middle_name": "DANIEL",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "904-543-1818",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "FL",
"license": "AL9976",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORLDNET - MEDICAID DIVERSION PROGRAM",
"identifier": "7618",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID WAIVER PROGRAM",
"identifier": "003102500",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN ELDERCARE - MEDICAID DIVERSION PROGRAM",
"identifier": "109168",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Gulf Breeze Courtyard",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Gulf Breeze, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.