Active NPI
Lesly'Leisure Living II
- Assisted Living Facility
- Tamarac, FL
National Provider Identifier
1750702783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- 11220
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002679100 | Medicaid | FL |
National Provider Directory
National Provider Directory- Tax ID family
- Lesly'Leisure Living II
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Assisted Living Facility
- Lauderhill, FL
- NPI 1871914614
-
- Assisted Living Facility
- Tamarac, FL
- NPI 1881940542
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.