Organization Active NPI

Pleasant Manor Alf LLC

  • Assisted Living Facility
  • Plant City, FL
National Provider Identifier
1639476583
Registry record updated Feb 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL6680 Issued in FL
Legal business name
PLEASANT MANOR ALF LLC
Practice address
6929 Durant Rd
Plant City, FL 33567-3266
Phone
(813) 737-1736
Fax
(813) 381-5330
NPI assigned
Feb 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2011

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

Authorized official

Name
Rogie A. Babas
Title
Owner/Manager
Phone
(813) 543-5800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL6680 FL Primary

Addresses

Primary practice location

6929 Durant Rd
Plant City, FL 33567-3266

Mailing address

6929 Durant Rd
Plant City, FL 33567-3266
Phone (813) 737-1736

Other identifiers 2

IdentifierTypeStateIssuer
001780600MedicaidFL
002066800MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1297382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297382400000",
    "number": "1639476583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6929 DURANT RD",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335673266",
            "telephone_number": "813-737-1736",
            "fax_number": "813-381-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6929 DURANT RD",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335673266",
            "telephone_number": "813-737-1736",
            "fax_number": "813-381-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLEASANT MANOR ALF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-11",
        "last_updated": "2011-02-11",
        "status": "A",
        "authorized_official_last_name": "BABAS",
        "authorized_official_first_name": "ROGIE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "813-543-5800"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL6680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001780600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002066800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plant City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2011; 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.