NPIMap

Organization Active NPI

Grand 14 LLC

  • Assisted Living Facility
  • Tampa, FL
National Provider Identifier
1598000705
Registry record updated Nov 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL10036 Issued in FL
Legal business name
GRAND 14 LLC
Practice address
10109 N Willow Ave
Tampa, FL 33612-7350
Phone
(813) 931-5599
Fax
(813) 931-4440
NPI assigned
Nov 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2012

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

Authorized official

Name
Ms. Arlene M Clemetson
Title
Administrator
Phone
(813) 931-5599

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL10036 FL Primary

Addresses

Primary practice location

10109 N Willow Ave
Tampa, FL 33612-7350

Mailing address

10109 N Willow Ave
Tampa, FL 33612-7350
Phone (813) 931-5599

Other names 1

  • SomePlace Like Home ALF Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1354147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354147200000",
    "number": "1598000705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10109 N WILLOW AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336127350",
            "telephone_number": "813-931-5599",
            "fax_number": "813-931-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10109 N WILLOW AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336127350",
            "telephone_number": "813-931-5599",
            "fax_number": "813-931-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND 14 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-29",
        "last_updated": "2012-11-29",
        "status": "A",
        "authorized_official_last_name": "CLEMETSON",
        "authorized_official_first_name": "ARLENE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "813-931-5599",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SomePlace Like Home ALF",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; 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.