NPIMap

Organization Active NPI

Nic 4 Royal Palm Leasing LLC

Doing business as Royal Palm Retirement Centre

  • Assisted Living Facility
  • Port Charlotte, FL
National Provider Identifier
1619318219
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
3915 Issued in FL
Legal business name
NIC 4 ROYAL PALM LEASING LLC
Doing business as
Royal Palm Retirement Centre
Practice address
2500 Aaron St.
Port Charlotte, FL 33952
Phone
(941) 627-6762
Fax
(941) 627-9890
NPI assigned
Jul 11, 2013
Last updated
Dec 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Authorized official

Name
Jane Ryu
Title
President/Ceo/Cfo
Phone
(212) 479-5270

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 3915 FL Primary

Addresses

Primary practice location

2500 Aaron St.
Port Charlotte, FL 33952

Mailing address

PO Box 1700, Nic 4 Royal Palm Leasing LLC
C/O Holiday Retirement
Lake Oswego, OR 97035
Phone (971) 245-8020

Other names 1

  • Royal Palm Retirement Centre 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": "1373500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1619318219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1700, NIC 4 ROYAL PALM LEASING LLC",
            "address_2": "C/O HOLIDAY RETIREMENT",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "97035",
            "telephone_number": "971-245-8020",
            "fax_number": "503-431-2295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 AARON ST.",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33952",
            "telephone_number": "941-627-6762",
            "fax_number": "941-627-9890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIC 4 ROYAL PALM LEASING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-11",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "RYU",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "PRESIDENT/CEO/CFO",
        "authorized_official_telephone_number": "212-479-5270"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "3915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Royal Palm Retirement Centre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; 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.