Well Trevi Tenant LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

WELL TREVI TENANT LLC

Practice address

1255 Pasadena Ave S # Souths
South Pasadena, FL 33707-6203

Phone

(727) 381-5411

NPI assigned

Jan 31, 2022

Organization subpart

No

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

Authorized official

Name

Mary Ellen Pisanelli

Title

Authorized Representative

Phone

(419) 247-2800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Fountains at Boca Ciega Bay Doing business as

Tax ID family

The Fountains at Boca Ciega Bay2 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.

• Well Trevi Tenant LLC

  • Home Health Agency
  • Tarboro, NC
  • NPI 1467113373
  NPD tax ID

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1821741877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 DORR ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436154040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 PASADENA AVE S # SOUTHS",
            "city": "SOUTH PASADENA",
            "state": "FL",
            "postal_code": "337076203",
            "telephone_number": "727-381-5411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL TREVI TENANT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-31",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "PISANELLI",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "419-247-2800"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA",
            "identifier": "83",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Fountains at Boca Ciega Bay",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Fountains at Boca Ciega Bay",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wal-Mart Stores East LP
• Yue Wang, OMD
• Watermark Boca Ciega Bay, LLC
• Wayne J. Garcia Mdpa
• Mark Weiskopf
• Wendy Lucker LLC
• West Florida - PPH, LLC
• West Florida - PPH, LLC
• Oswald Anthony Williams, MD
• Robert Winer

• Assisted Living Facility in South Pasadena, FL
• Providers in South Pasadena, 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 Jan 19, 2023; 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.