460 MRC LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

460 MRC LLC

Doing business as

Mayfield Retirement Center

Practice address

460 Newell Hill Rd
Leesburg, FL 34748-9247

Phone

(352) 365-6011

Fax

(352) 365-9923

NPI assigned

Dec 1, 2022

Last updated

Dec 1, 2022By 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

Ankur Shah

Title

Director

Phone

(321) 432-0675

Specialties & licenses 1

Addresses

Other names 1

• Mayfield Retirement Center Doing business as

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

{
    "created_epoch": "1669852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1689384539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 NEWELL HILL RD",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347489247",
            "telephone_number": "352-365-6011",
            "fax_number": "352-365-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 NEWELL HILL RD",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347489247",
            "telephone_number": "352-365-6011",
            "fax_number": "352-365-9923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "460 MRC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-11-28",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "ANKUR",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "321-432-0675"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mayfield Retirement Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Leesburg, FL
• Providers in Leesburg, 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 Dec 1, 2022; 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.