Community Assisted and Supported Living, Inc.

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

COMMUNITY ASSISTED AND SUPPORTED LIVING, INC.

Practice address

461 Van Buren St
Fort Myers, FL 33916-3740

Phone

(239) 922-1969

Fax

(941) 366-0033

NPI assigned

Mar 29, 2024

Last updated

Mar 29, 2024By 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

Julian S Eller

Title

Ceo

Phone

(941) 225-2373

Specialties & licenses 1

Addresses

Tax ID family

Community Assisted and Supported Living Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Community Assisted and Supported Living, Inc.

  dba Renaissance Manor

  • Assisted Living Facility (Mental Illness)
  • Sarasota, FL
  • NPI 1902112659
  NPD tax ID
• Community Assisted and Supported Living, Inc.

  dba Renaissance Manor

  • Case Management Agency
  • Sarasota, FL
  • NPI 1982862686
  NPD tax ID

Locations

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

{
    "created_epoch": "1711670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711670400000",
    "number": "1740031533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 FRUITVILLE RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342375320",
            "telephone_number": "941-928-1814",
            "fax_number": "941-366-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 VAN BUREN ST",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339163740",
            "telephone_number": "239-922-1969",
            "fax_number": "941-366-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY ASSISTED AND SUPPORTED LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-29",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A",
        "authorized_official_last_name": "ELLER",
        "authorized_official_first_name": "JULIAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "941-225-2373"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Mental Illness Community Based Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.