Amber Place

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

AL11222 Issued in FL

Legal business name

AMBER PLACE

Practice address

2365 W Amber PL
Citrus Springs, FL 34434-4006

Phone

(352) 489-6444

Fax

(352) 489-6444

NPI assigned

Dec 6, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Marcia Angella Wellington

Title

Administrator

Phone

(352) 489-6444

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291593600000",
    "number": "1558664078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2365 W AMBER PL",
            "city": "CITRUS SPRINGS",
            "state": "FL",
            "postal_code": "344344006",
            "telephone_number": "352-489-6444",
            "fax_number": "352-489-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 W AMBER PL",
            "city": "CITRUS SPRINGS",
            "state": "FL",
            "postal_code": "344344006",
            "telephone_number": "352-489-6444",
            "fax_number": "352-489-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBER PLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-06",
        "last_updated": "2010-12-06",
        "status": "A",
        "authorized_official_last_name": "WELLINGTON",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "ANGELLA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "352-489-6444",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": "AL11222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "692012896",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; 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.