NPIMap

Organization Active NPI

Santa Susana Alf Inc

  • Assisted Living Facility
  • Tampa, FL
National Provider Identifier
1609271519
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL12568 Issued in FL
Legal business name
SANTA SUSANA ALF INC
Practice address
11407 Larkwood Way
Tampa, FL 33625-5608
Phone
(813) 962-5741
Fax
(813) 962-5741
NPI assigned
Nov 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Authorized official

Name
Deiby R Jacinto
Title
Owner/Administration
Phone
(813) 541-0093

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL12568 FL Primary

Addresses

Primary practice location

11407 Larkwood Way
Tampa, FL 33625-5608

Mailing address

11407 Larkwood Way
Tampa, FL 33625-5608
Phone (813) 962-5741

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415059200000",
    "number": "1609271519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11407 LARKWOOD WAY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336255608",
            "telephone_number": "813-962-5741",
            "fax_number": "813-962-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11407 LARKWOOD WAY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336255608",
            "telephone_number": "813-962-5741",
            "fax_number": "813-962-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA SUSANA ALF INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-04",
        "last_updated": "2014-11-04",
        "status": "A",
        "authorized_official_last_name": "JACINTO",
        "authorized_official_first_name": "DEIBY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATION",
        "authorized_official_telephone_number": "813-541-0093"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 4, 2014; 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.