Summit Retirement Lifestyles C

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ALF # 12250 Issued in FL

Legal business name

SUMMIT RETIREMENT LIFESTYLES C

Doing business as

The Legacy @ St. Johns

Practice address

100 Hillcrest Heights Ave
Saint Johns, FL 32259-7970

Phone

(904) 201-6999

NPI assigned

May 22, 2014

Organization subpart

No

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

Authorized official

Name

Freddie Mayonte Arguilla

Title

President

Phone

(904) 201-6999

Specialties & licenses 1

Addresses

Other names 1

• The Legacy @ St. Johns Doing business as

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400716800000",
    "number": "1649682865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HILLCREST HEIGHTS AVE",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322597970",
            "telephone_number": "904-201-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HILLCREST HEIGHTS AVE",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322597970",
            "telephone_number": "904-201-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT RETIREMENT LIFESTYLES C",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-22",
        "last_updated": "2014-05-22",
        "status": "A",
        "authorized_official_last_name": "ARGUILLA",
        "authorized_official_first_name": "FREDDIE",
        "authorized_official_middle_name": "MAYONTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-201-6999"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "ALF # 12250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Legacy @ St. Johns",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Ann Sticken, APRN
• Ryan Christopher Stoner, M.D.
• Stoneway Behavioral Services
• Elizabeth Strickland, PT, DPT
• Laura Grace Sullivan, DMD
• T.C.I. Therapy, LLC
• Hailey Marie Taber
• Ryan Tantay
• Michelle Christy Taveras, MSW, PSY.D.
• Elana D Taylor, PHARMD

• Assisted Living Facility in Saint Johns, FL
• Providers in Saint Johns, 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 May 22, 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.