Varnum'S Rest Home, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

VARNUM'S REST HOME, LLC

Practice address

12167 NW Freeman Rd
Bristol, FL 32321-3019

Phone

(850) 643-5155

Fax

(850) 643-3721

NPI assigned

Jan 12, 2024

Organization subpart

No

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

Authorized official

Name

Ruby VarnumNPI 1538400072

Title

Owner

Phone

(850) 643-5155

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ruby Lee Varnum

  • Assisted Living Facility
  • Bristol, FL
  • NPI 1538400072
  NPD Authorized official

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

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1851162390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12167 NW FREEMAN RD",
            "city": "BRISTOL",
            "state": "FL",
            "postal_code": "323213019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12167 NW FREEMAN RD",
            "city": "BRISTOL",
            "state": "FL",
            "postal_code": "323213019",
            "telephone_number": "850-643-5155",
            "fax_number": "850-643-3721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VARNUM'S REST HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "VARNUM",
        "authorized_official_first_name": "RUBY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-643-5155"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gidgetta Thomas, LPN
• Twin Oaks Juvenile Development
• Twin Oaks Juvenile Development, Inc
• Elyse Wahlquist Van Wagenen, MA CCC SLP
• Ruby Lee Varnum
• Lindsay Wahila, LMHC
• Hammadah Talib Wahlquist
• Jordan Sims Wahlquist, M.S.
• Lynne Howell Wahlquist
• Megan Walker

• Assisted Living Facility in Bristol, FL
• Providers in Bristol, 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 12, 2024; 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.