SH Heron Club, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SH HERON CLUB, LLC

Practice address

3749 Sarasota Square Blvd
Sarasota, FL 34238-4595

Phone

(941) 922-1669

NPI assigned

Apr 25, 2019

Organization subpart

No

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

Authorized official

Name

Seth Walker

Title

Cfo, Sri Management

Phone

(850) 583-7990

Specialties & licenses 1

Addresses

Other names 1

• Heron Club Doing business as

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556150400000",
    "number": "1780248617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2573 BARRINGTON CIR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323086805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3749 SARASOTA SQUARE BLVD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342384595",
            "telephone_number": "941-922-1669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SH HERON CLUB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-04-25",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "SETH",
        "authorized_official_title_or_position": "CFO, SRI MANAGEMENT",
        "authorized_official_telephone_number": "850-583-7990"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heron Club",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kadeen Elizabeth Sewell
• Sex and Love Therapist, LLC
• Mario Sexton, PTA
• Christopher R. Sforzo, M.D.
• Melinda Sganga, PT
• SH Heron East, LLC
• SH Heron House, LLC
• Pamela D Shackley
• Shadrick Kralik MD PA
• Dana Shaevitch, CGC

• Assisted Living Facility in Sarasota, FL
• Providers in Sarasota, 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 Apr 25, 2019; 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.