Deltona Home of TLC Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

6905138 Issued in FL

Legal business name

DELTONA HOME OF TLC INC.

Practice address

1287 Deltona Blvd
Spring Hill, FL 34606

Phone

(352) 683-5255

Fax

(352) 683-2903

NPI assigned

Nov 15, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Cheri L. Long

Title

Owner Adminstrator

Phone

(352) 683-5255

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384473600000",
    "number": "1578993200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1287 DELTONA BLVD",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346064408",
            "telephone_number": "352-683-5255",
            "fax_number": "352-683-2903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1287 DELTONA BLVD",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "34606",
            "telephone_number": "352-683-5255",
            "fax_number": "352-683-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTONA HOME OF TLC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-15",
        "last_updated": "2013-11-15",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "CHERI",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER ADMINSTRATOR",
        "authorized_official_telephone_number": "352-683-5255",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": "6905138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "691238996",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "691238998",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1414178",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Isaiah Delpilar, COTA/L
• Deluca & Ressel LLC
• Guesly J Delva, M.D.
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• Leslie Ann Demos, APRN
• Denise Schonwald, LLC

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Spring Hill, FL
• Providers in Spring Hill, FL by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.