Beacon Villa Alf Operating LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BEACON VILLA ALF OPERATING LLC

Practice address

141 Kaelyn LN
Port St Joe, FL 32456-6180

Phone

(850) 647-4000

Fax

(850) 647-4004

NPI assigned

Jan 22, 2013

Organization subpart

No

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

Authorized official

Name

Liza Rojas

Title

Manager

Phone

(941) 809-6147

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1358812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358812800000",
    "number": "1578801866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 KAELYN LN",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324566180",
            "telephone_number": "850-647-4000",
            "fax_number": "850-647-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 KAELYN LN",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324566180",
            "telephone_number": "850-647-4000",
            "fax_number": "850-647-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON VILLA ALF OPERATING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-22",
        "last_updated": "2013-01-22",
        "status": "A",
        "authorized_official_last_name": "ROJAS",
        "authorized_official_first_name": "LIZA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "941-809-6147"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ascension Sacred Heart Gulf
• Kristie L Ash
• Ashten Mikaela Bailey, OTR/L
• Monica Barfield, ARNP
• Beacon by the Bay LLC
• Brittany Jade Beauchamp, APRN
• Ellen Berkowitz, MD
• Rachel Marie Bixler, M.D.
• Board of County Commissioners Gulf County
• Alexandra Boulanger, RBT

• All providers in Port St Joe, FL
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.

Verify at the official NPI Registry.