Organization Active NPI

Lesly'Leisure Living II

  • Assisted Living Facility
  • Tamarac, FL
National Provider Identifier
1750702783
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
11220 Issued in FL
Legal business name
LESLY'LEISURE LIVING II
Practice address
6461 NW 90TH Ave
Tamarac, FL 33321-3621
Phone
(954) 724-5470
Fax
(954) 721-9171
NPI assigned
Dec 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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

Authorized official

Name
Marc R Thelot
Title
Assistant Administrator
Phone
(954) 661-1285

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 11220 FL Primary

Addresses

Primary practice location

6461 NW 90TH Ave
Tamarac, FL 33321-3621

Mailing address

6461 NW 90TH Ave
Tamarac, FL 33321-3621
Phone (954) 724-5470

Other identifiers 1

IdentifierTypeStateIssuer
002679100MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Lesly'Leisure Living II3 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.

NPI Registry JSON

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

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387238400000",
    "number": "1750702783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6461 NW 90TH AVE",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333213621",
            "telephone_number": "954-724-5470",
            "fax_number": "954-721-9171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6461 NW 90TH AVE",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333213621",
            "telephone_number": "954-724-5470",
            "fax_number": "954-721-9171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESLY'LEISURE LIVING II",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-17",
        "last_updated": "2013-12-17",
        "status": "A",
        "authorized_official_last_name": "THELOT",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
        "authorized_official_telephone_number": "954-661-1285"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "11220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002679100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.