Indian Oaks Incorporated

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL6056 Issued in FL

Legal business name

INDIAN OAKS INCORPORATED

Doing business as

Indian Oaks Manor

Practice address

11355 131St Street North
Largo, FL 33774

Phone

(727) 593-0403

NPI assigned

Nov 28, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Stewart Ryan Erickson

Title

President

Phone

(727) 593-0403

Specialties & licenses 1

Addresses

Other names 1

• Indian Oaks Manor Doing business as

Locations

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1699957068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11355 131ST STREET NORTH",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "33774",
            "telephone_number": "727-593-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11355 131ST STREET NORTH",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "33774",
            "telephone_number": "727-593-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN OAKS INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "STEWART",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-593-0403",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL6056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indian Oaks Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Leann Sarah Infante, BCBA

• Assisted Living Facility in Largo, FL
• Providers in Largo, 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 Nov 28, 2007; 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.