Deland FL Alf Opco LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

DELAND FL ALF OPCO LLC

Practice address

436 N McDonald Ave
Deland, FL 32724-3634

Phone

(386) 736-5800

NPI assigned

Jul 26, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Ben Fried

Title

Coo

Phone

(646) 290-1489

Specialties & licenses 1

Addresses

Other names 1

• Blue Palms Senior Living of Deland Doing business as

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

{
    "created_epoch": "1690329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1760163547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16690 COLLINS AVE STE 804",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331605685",
            "telephone_number": "305-298-2665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 N MCDONALD AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327243634",
            "telephone_number": "386-736-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAND FL ALF OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-26",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "FRIED",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "646-290-1489",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Palms Senior Living of Deland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Deland, FL
• Providers in Deland, 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 Apr 18, 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.