Cedar Creek Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CEDAR CREEK ASSISTED LIVING LLC

Practice address

4279 Judith Ave
Merritt Island, FL 32953-8166

Phone

(321) 454-7768

NPI assigned

Jan 30, 2023

Last updated

Jul 26, 2023By 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

Savitri Johnson

Title

Administrative Asst / Ar

Phone

(863) 226-0358

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690329600000",
    "number": "1720794068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 519",
            "city": "AUBURNDALE",
            "state": "FL",
            "postal_code": "338230519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4279 JUDITH AVE",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329538166",
            "telephone_number": "321-454-7768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR CREEK ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SAVITRI",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASST / AR",
        "authorized_official_telephone_number": "863-226-0358"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Carter, M.A., CCC-SLP
• Lisa Cassiere, COTA/L
• Ryan Lee Caudill, DMD, MSD, PA
• Kimberlee Ann Cavanaugh, ARNP-C
• CDPG, P.L. (Christie Dental of Merritt Island)
• Central Florida Holistic Health and Wellness Consultants LLC (Healthy Healing Acupuncture)
• Certified Diabetic & Medical Services, Inc (Certified Diabetic & Medical Supplies)
• Jean M Cervini-Koby, ARNP-FNP-C
• Amber Diane Chambers, APRN CNM
• Virginia Chan, PT

• Assisted Living Facility in Merritt Island, FL
• Providers in Merritt Island, 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 Jul 26, 2023; 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.