Organization Active NPI

Aravilla Clearwater

  • Assisted Living Facility
  • Clearwater, FL
National Provider Identifier
1720655442
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
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, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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)CodeLicenseStatePrimary
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 Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2238238Aravilla Clearwater3055 Union St, Clearwater, FL 33759Certificate of waiverSep 30, 2027

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.