Summer Time Lodge, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL5492 Issued in FL

Legal business name

SUMMER TIME LODGE, INC.

Practice address

909 N Wymore Rd
Winter Park, FL 32789-1769

Phone

(407) 645-5515

NPI assigned

Aug 28, 2014

Organization subpart

No

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

Authorized official

Name

Eshley May Pacamalan

Title

Treasurer

Phone

(407) 645-5515

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409184000000",
    "number": "1679973515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 N WYMORE RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327891769",
            "telephone_number": "407-645-5515",
            "fax_number": "407-599-5539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 N WYMORE RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327891769",
            "telephone_number": "407-645-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMER TIME LODGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-28",
        "last_updated": "2014-08-28",
        "status": "A",
        "authorized_official_last_name": "PACAMALAN",
        "authorized_official_first_name": "ESHLEY MAY",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "407-645-5515"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL5492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140828300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Winter Park, FL
• Providers in Winter Park, 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 28, 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.