Active NPI
Aravilla Clearwater
- Assisted Living Facility
- Clearwater, FL
National Provider Identifier
1720655442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- ARAVILLA CLEARWATER
- Doing business as
- Aravilla Clearwater
- Practice address
- 3055 Union St
Clearwater, FL 33759 - Phone
- (727) 260-2826
- Fax
- (727) 400-4272
- NPI assigned
- Jun 10, 2021
- Last updated
- Jun 10, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Dawn Grady
- Title
- Executive Director
- Phone
- (813) 363-5263
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Primary |
Addresses
Primary practice location
3055 Union St
Clearwater, FL 33759
Mailing address
3055 Union St
Clearwater, FL 33759
Phone (727) 260-2826
Other names 1
- Aravilla Clearwater
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2238238 | Aravilla Clearwater | Certificate of waiver | Sep 30, 2027 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623283200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1623283200000",
"number": "1720655442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3055 UNION ST",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "33759",
"telephone_number": "727-260-2826",
"fax_number": "727-400-4272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3055 UNION ST",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "33759",
"telephone_number": "727-260-2826",
"fax_number": "727-400-4272"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ARAVILLA CLEARWATER",
"organizational_subpart": "NO",
"enumeration_date": "2021-06-10",
"last_updated": "2021-06-10",
"certification_date": "2021-05-25",
"status": "A",
"authorized_official_last_name": "GRADY",
"authorized_official_first_name": "DAWN",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "813-363-5263",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Aravilla Clearwater",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.