NPIMap

Organization Active NPI

House of Light Senior Living III

  • Assisted Living Facility
  • Melbourne, FL
National Provider Identifier
1760885784
Registry record updated Oct 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
HOUSE OF LIGHT SENIOR LIVING III
Practice address
2306 Woodlawn Cir
Melbourne, FL 32934-7645
Phone
(321) 368-5611
Fax
(321) 345-5925
NPI assigned
Oct 4, 2014
Last updated
Oct 4, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
HOUSE OF LIGHT SENIOR LIVING, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 4, 2014

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

Authorized official

Name
Ms. Viviene Cornetta Moore
Title
Administrator
Phone
(321) 368-5611

Specialties & licenses 1

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

Addresses

Primary practice location

2306 Woodlawn Cir
Melbourne, FL 32934-7645

Mailing address

2306 Woodlawn Cir
Melbourne, FL 32934-7645
Phone (321) 368-5611

National Provider Directory

National Provider Directory
Tax ID family
House of Light Senior Living III3 organizations share this tax ID, including this one
Part of
House of Light Senior Living III

Other organizations with this tax ID 2

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1412380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412380800000",
    "number": "1760885784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 WOODLAWN CIR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329347645",
            "telephone_number": "321-368-5611",
            "fax_number": "321-345-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2306 WOODLAWN CIR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329347645",
            "telephone_number": "321-368-5611",
            "fax_number": "321-345-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSE OF LIGHT SENIOR LIVING III",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOUSE OF LIGHT SENIOR LIVING, LLC",
        "enumeration_date": "2014-10-04",
        "last_updated": "2014-10-04",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "VIVIENE",
        "authorized_official_middle_name": "CORNETTA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "321-368-5611",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2014; 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.