Shifting Sands Adult Day Center, LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

SHIFTING SANDS ADULT DAY CENTER, LLC

Practice address

28410 Bonita Crossings Blvd Unit 7
Bonita Springs, FL 34135-3211

Phone

(239) 405-7009

NPI assigned

May 6, 2019

Organization subpart

No

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

Authorized official

Name

Tammy Wilkinson, RN

Title

Administrator

Phone

(239) 405-7009

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1841855822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28410 BONITA CROSSINGS BLVD UNIT 7",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341353211",
            "telephone_number": "239-777-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28410 BONITA CROSSINGS BLVD UNIT 7",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341353211",
            "telephone_number": "239-405-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIFTING SANDS ADULT DAY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-06",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "239-405-7009",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101754500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Day Care Clinic/Center in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Adult Day Care Clinic/Center in Florida

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