Island Splendor Alf Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL11915 Issued in FL

Legal business name

ISLAND SPLENDOR ALF INC.

Practice address

9057 109TH Ave
Seminole, FL 33777-1115

Phone

(727) 585-9788

Fax

(727) 204-6549

NPI assigned

Dec 17, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Elsa Johnson

Title

Administrator

Phone

(727) 585-9788

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Island Splendor Alf Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Island Splendor Alf, Inc

  • Assisted Living Facility
  • Largo, FL
  • NPI 1114074226
  NPD tax ID

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

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387238400000",
    "number": "1801217914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 18TH AVE SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337781116",
            "telephone_number": "727-585-9788",
            "fax_number": "727-204-6549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9057 109TH AVE",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337771115",
            "telephone_number": "727-585-9788",
            "fax_number": "727-204-6549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND SPLENDOR ALF INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-17",
        "last_updated": "2013-12-17",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ELSA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "727-585-9788",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL11915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003477600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Colette Iwanski
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• Alec Jackson
• Carie Jackson, D.C.
• Jeanette Marie Jacques, MA, CCC-SLP

• Assisted Living Facility in Seminole, FL
• Providers in Seminole, 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 17, 2013; 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.