NPIMap

Organization Active NPI

Senior Living Properties III, LLC

  • Assisted Living Facility
  • Saint Cloud, FL
National Provider Identifier
1750981841
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
SENIOR LIVING PROPERTIES III, LLC
Doing business as
Savannah Court of St. Cloud
Practice address
3791 Old Canoe Creek Rd
Saint Cloud, FL 34769-6630
Phone
(407) 892-8502
NPI assigned
Oct 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Authorized official

Name
Stephanie Tucker
Title
Billing Specialist
Phone
(954) 691-1030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

3791 Old Canoe Creek Rd
Saint Cloud, FL 34769-6630

Mailing address

4611 Johnson Rd Unit 1
Coconut Creek, FL 33073-4361
Phone (954) 691-1030

Other identifiers 1

IdentifierTypeStateIssuer
008616500MedicaidFL

Other names 1

  • Savannah Court of St. Cloud Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Savannah Cottage of Lakeland8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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": "1603843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631664000000",
    "number": "1750981841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 JOHNSON RD UNIT 1",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734361",
            "telephone_number": "954-691-1030",
            "fax_number": "954-691-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3791 OLD CANOE CREEK RD",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696630",
            "telephone_number": "407-892-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR LIVING PROPERTIES III, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-28",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "954-691-1030"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008616500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Savannah Court of St. Cloud",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.