NPIMap

Organization Active NPI

Judith's Assisted Living Facility, Inc

Doing business as Yudith's Alf

  • Assisted Living Facility
  • Tampa, FL
National Provider Identifier
1831520246
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
9484 Issued in FL
Legal business name
JUDITH'S ASSISTED LIVING FACILITY, INC
Doing business as
Yudith's Alf
Practice address
4542 West Hiawatha Street
Tampa, FL 33614
Phone
(813) 453-4542
Fax
(813) 412-7830
NPI assigned
Dec 11, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Authorized official

Name
Ruben Domoguez
Title
Administrator
Phone
(813) 453-2480

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 9484 FL Primary

Addresses

Primary practice location

4542 West Hiawatha Street
Tampa, FL 33614

Mailing address

4542 West Hiawatha Street
Tampa, FL 33614
Phone (813) 453-4542

Other names 1

  • Yudith's Alf Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dba Yudith's Assisted Living Facility II2 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.

NPI Registry JSON

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

{
    "created_epoch": "1386720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386720000000",
    "number": "1831520246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4542 WEST HIAWATHA STREET",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33614",
            "telephone_number": "813-453-4542",
            "fax_number": "813-412-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4542 WEST HIAWATHA STREET",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33614",
            "telephone_number": "813-453-4542",
            "fax_number": "813-412-7830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDITH'S ASSISTED LIVING FACILITY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-11",
        "last_updated": "2013-12-11",
        "status": "A",
        "authorized_official_last_name": "DOMOGUEZ",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "813-453-2480"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "9484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yudith's Alf",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.