The Bougainvilla House, Inc.

Primary specialty

Recovery Care Clinic/CenterTaxonomy code 261QR0800X

Legal business name

THE BOUGAINVILLA HOUSE, INC.

Practice address

1727 SE 4TH Ave
Fort Lauderdale, FL 33316-2515

Phone

(954) 764-7337

Fax

(954) 764-6283

NPI assigned

Jan 4, 2016

Organization subpart

No

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

Authorized official

Name

Keli Kornmiller

Title

Senior Credentialing Specialist

Phone

(561) 672-8345

Specialties & licenses 2

Addresses

Tax ID family

The Bougainvilla House Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Hospicecare of Southeast Florida, Inc.

  • Community Based Hospice Care Agency
  • Fort Lauderdale, FL
  • NPI 1124036298
  NPD tax ID
• The Bougainvilla House, Inc.

  • Recovery Care Clinic/Center
  • Fort Lauderdale, FL
  • NPI 1700243300
  NPD tax ID
• The Bougainvilla House, Inc.

  • Community/Behavioral Health Agency
  • Fort Lauderdale, FL
  • NPI 1962835488
  NPD tax ID

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

{
    "created_epoch": "1451865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453852800000",
    "number": "1770949075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 SE 4TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162515",
            "telephone_number": "954-764-7337",
            "fax_number": "954-764-6283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 SE 4TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162515",
            "telephone_number": "954-764-7337",
            "fax_number": "954-764-6283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BOUGAINVILLA HOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-04",
        "last_updated": "2016-01-27",
        "status": "A",
        "authorized_official_last_name": "KORNMILLER",
        "authorized_official_first_name": "KELI",
        "authorized_official_title_or_position": "SENIOR CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "561-672-8345"
    },
    "taxonomies": [
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "FL",
            "license": "1706AD094501",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Krystal Thayer, PH.D.
• The Angel'S Touch Assisting Living LLC
• The Ark Nutrition and Wellness Center
• The Blue Tree Cafe Limited Liability Co.
• The Bougainvilla House, Inc.
• The Bougainvilla House, Inc.
• The Caring Group, Inc.
• The Caring Place
• The Center for Positive Growth, PLLC
• The Children'S Home Society of Florida

• Recovery Care Clinic/Center in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Recovery Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; 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.