NPIMap

Organization Active NPI

Treasure Coast Assisted Living, LLC

Doing business as Castlewood Assisted Living Residence, LLC

  • Assisted Living Facility
  • Vero Beach, FL
National Provider Identifier
1659133577
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
TREASURE COAST ASSISTED LIVING, LLC
Doing business as
Castlewood Assisted Living Residence, LLC
Practice address
1914 21St St
Vero Beach, FL 32960-3489
Phone
(772) 567-6769
Fax
(772) 567-5289
NPI assigned
Jan 25, 2024
Organization subpart
Yes
Parent organization
CASTLEWOOD ASSISTED LIVING RESIDENCE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Authorized official

Name
Patricia Pacaud Brezault
Title
Administrator
Phone
(772) 567-6769

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

1914 21St St
Vero Beach, FL 32960-3489

Mailing address

1914 21St St
Vero Beach, FL 32960-3489
Phone (772) 567-6769

Other identifiers 2

IdentifierTypeStateIssuer
13755OtherFLLICENSE
116694600MedicaidFL

Other names 1

  • CASTLEWOOD ASSISTED LIVING RESIDENCE, LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Treasure Coast Assisted Living LLC2 organizations share this tax ID, including this one
Part of
Treasure Coast Assisted Living LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1659133577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1914 21ST ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329603489",
            "telephone_number": "772-567-6769",
            "fax_number": "772-567-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1914 21ST ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329603489",
            "telephone_number": "772-567-6769",
            "fax_number": "772-567-5289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREASURE COAST ASSISTED LIVING, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CASTLEWOOD ASSISTED LIVING RESIDENCE, LLC",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-07-01",
        "certification_date": "2024-06-30",
        "status": "A",
        "authorized_official_last_name": "PACAUD BREZAULT",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "772-567-6769"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "13755",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116694600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CASTLEWOOD ASSISTED LIVING RESIDENCE, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CASTLEWOOD ASSISTED LIVING RESIDENCE, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.