Ambassador Soars Supportive Living and Transportation Services, Inc

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

AMBASSADOR SOARS SUPPORTIVE LIVING AND TRANSPORTATION SERVICES, INC

Practice address

5006 Trouble Creek Rd Ste 101
New Port Richey, FL 34652-4937

Phone

(727) 557-5995

NPI assigned

Sep 29, 2021

Organization subpart

No

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

Authorized official

Name

Dwaimeon M JordanNPI 1942844550

Title

President

Phone

(727) 557-5995

Specialties & licenses 4

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Dwaimeon Jordan

  • In Home Supportive Care Agency
  • New Port Richey, FL
  • NPI 1942844550
  NPD Authorized official

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632873600000",
    "number": "1558033548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5317 ANHINGA TRL",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346537032",
            "telephone_number": "727-557-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5006 TROUBLE CREEK RD STE 101",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346524937",
            "telephone_number": "727-557-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBASSADOR SOARS SUPPORTIVE LIVING AND TRANSPORTATION SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-29",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "DWAIMEON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-557-5995"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104733300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in New Port Richey, FL
• Providers in New Port Richey, FL by specialty
• In Home Supportive Care Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.