Johanna,S Assisted Living Facility Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL11332 Issued in FL

Legal business name

JOHANNA,S ASSISTED LIVING FACILITY INC

Practice address

1958 SW Dorado LN
Port St Lucie, FL 34953-1825

Phone

(772) 873-5602

NPI assigned

Nov 18, 2009

Last updated

Dec 3, 2009By 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

Joanna Gilchrist

Title

Administrator

Phone

(772) 519-2061

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259798400000",
    "number": "1770811473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1958 SW DORADO LN",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349531825",
            "telephone_number": "772-873-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1958 SW DORADO LN",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349531825",
            "telephone_number": "772-873-5602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHANNA,S ASSISTED LIVING FACILITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-18",
        "last_updated": "2009-12-03",
        "status": "A",
        "authorized_official_last_name": "GILCHRIST",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "772-519-2061"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL11332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Port St Lucie, FL
• Providers in Port St Lucie, 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 Dec 3, 2009; 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.