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  • Assisted Living Facility
  • Orlando, FL
National Provider Identifier
1639333495
Registry record updated Jul 10, 2008
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Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL10413 Issued in FL
Legal business name
PROVIDENCE HOME
Practice address
8544 Park Highland Dr
Orlando, FL 32818-5770
Phone
(407) 953-5657
NPI assigned
Jul 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Authorized official

Name
Veronica Lawrence-Pokima
Title
Administrator
Phone
(407) 953-5657

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL10413 FL Primary

Addresses

Primary practice location

8544 Park Highland Dr
Orlando, FL 32818-5770

Mailing address

8544 Park Highland Dr
Orlando, FL 32818-5770
Phone (407) 953-5657

Other identifiers 1

IdentifierTypeStateIssuer
687327800MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1639333495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8544 PARK HIGHLAND DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328185770",
            "telephone_number": "407-953-5657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8544 PARK HIGHLAND DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328185770",
            "telephone_number": "407-953-5657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-10",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE-POKIMA",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "407-953-5657"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "687327800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.