Swan S.P. Enterprises

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SWAN S.P. ENTERPRISES

Doing business as

PROMISE MANOR WELLCARE

Practice address

45 W 17TH St
Riviera Beach, FL 33404-6121

Phone

(561) 863-7481

Fax

(561) 863-7396

NPI assigned

Oct 20, 2014

Organization subpart

Yes

Parent organization

SWAN S P ENTERPRISESAs reported in NPPES

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

Authorized official

Name

Sandra M Cameron

Title

Administrator

Phone

(561) 863-7481

Specialties & licenses 3

Addresses

Other names 1

• PROMISE MANOR WELLCARE Doing business as

Tax ID family

Swan SP Enterprises2 organizations share this tax ID, including this one

Part of

Swan SP Enterprises

Other organizations with this tax ID 1

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

• Swan S.P. Enterprises

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Riviera Beach, FL
  • NPI 1942605548
  NPD tax ID

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

{
    "created_epoch": "1413763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413763200000",
    "number": "1710381736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 W 17TH ST",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334046121",
            "telephone_number": "561-863-7481",
            "fax_number": "561-863-7396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W 17TH ST",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334046121",
            "telephone_number": "561-863-7481",
            "fax_number": "561-863-7396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWAN S.P. ENTERPRISES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SWAN S P ENTERPRISES",
        "enumeration_date": "2014-10-20",
        "last_updated": "2014-10-20",
        "status": "A",
        "authorized_official_last_name": "CAMERON",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "561-863-7481"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROMISE MANOR WELLCARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Sunshine Healthcare Group, LLC
• Support Services Network, Inc.
• Jannie Sutherland
• Swan S.P. Enterprises
• Scott Duane Swan, RN
• Karrah Sweetman
• Kate Ann Swett, RKT
• Jerry Scott Swyers, M.D.

• Assisted Living Facility in Riviera Beach, FL
• Providers in Riviera Beach, 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 Oct 20, 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.