Favor Memorycare Assisted Living Facility Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

13066 Issued in FL

Legal business name

FAVOR MEMORYCARE ASSISTED LIVING FACILITY INC

Practice address

385 E Wildmere Ave
Longwood, FL 32750-5537

Phone

(407) 951-6926

NPI assigned

Oct 10, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Peter Etoh

Title

Owner/Administrator

Phone

(407) 415-5064

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Favor Memorycare assisted living facility inc Other name

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1780194258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 E WILDMERE AVE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505537",
            "telephone_number": "407-951-6926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 E WILDMERE AVE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505537",
            "telephone_number": "407-951-6926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAVOR MEMORYCARE ASSISTED LIVING FACILITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-10",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "ETOH",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "407-415-5064",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": "13066",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "13066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720418635",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Favor Memorycare assisted living facility inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Assisted Living Facility in Longwood, FL
• Providers in Longwood, 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 Jun 16, 2018; 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.