Micasa Alf LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MICASA ALF LLC

Doing business as

Micasa Senior Living

Practice address

6021 Duval St
Hollywood, FL 33024-7961

Phone

(954) 613-1163

NPI assigned

Apr 4, 2019

Last updated

Aug 10, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Rozenberg

Title

Owner

Phone

(954) 646-1212

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• MICASA SENIOR LIVING Doing business as

Locations

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597017600000",
    "number": "1639631054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 SW 56TH CT",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333147004",
            "telephone_number": "954-613-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6021 DUVAL ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330247961",
            "telephone_number": "954-613-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICASA ALF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-04",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A",
        "authorized_official_last_name": "ROZENBERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-646-1212"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AL13462",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106326300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MICASA SENIOR LIVING",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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.