2450 Chateau LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

2450 CHATEAU LLC

Doing business as

RM Group Home

Practice address

815 Abbeville CT
Kissimmee, FL 34759-3426

Phone

(407) 738-0586

Fax

(321) 250-7463

NPI assigned

Jan 16, 2020

Last updated

Jan 16, 2020By 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

Carmen M Rivera, PHD

Title

President

Phone

(407) 738-0586

Specialties & licenses 1

Addresses

Other names 1

• RM Group Home Doing business as

Tax ID family

2450 Chateau LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Reborn Therapy Center

  dba Chateau Group Home

  • Adolescent and Children Mental Health Clinic/Center
  • Kissimmee, FL
  • NPI 1730710211
  NPD tax ID

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

{
    "created_epoch": "1579132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579132800000",
    "number": "1548890700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 W IRLO BRONSON MEMORIAL HWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347465325",
            "telephone_number": "407-738-0586",
            "fax_number": "321-250-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 ABBEVILLE CT",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347593426",
            "telephone_number": "407-738-0586",
            "fax_number": "321-250-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2450 CHATEAU LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-16",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-738-0586",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RM Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Developmental Disabilities Clinic/Center in Kissimmee, FL
• Providers in Kissimmee, 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 Jan 16, 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.