NPIMap

Organization Active NPI

Gardens Retreat, Inc.

  • Assisted Living Facility
  • Palm City, FL
National Provider Identifier
1841457413
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL11039 Issued in FL
Legal business name
GARDENS RETREAT, INC.
Practice address
4405 SW 72ND Ave
Palm City, FL 34990-5368
Phone
(772) 287-9713
Fax
(772) 287-9713
NPI assigned
May 20, 2008
Last updated
May 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Authorized official

Name
Mr. Walter Leslie Ellis
Title
Administrator
Phone
(772) 287-9713

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL11039 FL Primary

Addresses

Primary practice location

4405 SW 72ND Ave
Palm City, FL 34990-5368

Mailing address

4405 SW 72ND Ave
Palm City, FL 34990-5368
Phone (772) 287-9713

National Provider Directory

National Provider Directory
Tax ID family
Gardens Retreat2 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": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1841457413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 SW 72ND AVE",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349905368",
            "telephone_number": "772-287-9713",
            "fax_number": "772-287-9713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 SW 72ND AVE",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349905368",
            "telephone_number": "772-287-9713",
            "fax_number": "772-287-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDENS RETREAT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "LESLIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "772-287-9713",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL11039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.