Spruce Creek Assisted Living Facility , Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

12422 Issued in FL

Legal business name

SPRUCE CREEK ASSISTED LIVING FACILITY , INC.

Practice address

260 Spring Forest Dr
New Smyrna Beach, FL 32168-8700

Phone

(386) 527-3781

NPI assigned

May 23, 2014

Last updated

May 23, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tamela Sue Owens

Title

Administrator

Phone

(386) 527-3781

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400803200000",
    "number": "1760894810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 SPRING FOREST DR",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321688700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 SPRING FOREST DR",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321688700",
            "telephone_number": "386-527-3781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRUCE CREEK ASSISTED LIVING FACILITY , INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-23",
        "last_updated": "2014-05-23",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "TAMELA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "386-527-3781",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "12422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in New Smyrna Beach, FL
• Providers in New Smyrna Beach, 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 May 23, 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.