Glenville Pines Assisted Living Facility

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12126 Issued in FL

Legal business name

GLENVILLE PINES ASSISTED LIVING FACILITY

Practice address

1351 Steele Rd SE
Palm Bay, FL 32909-5332

Phone

(321) 984-7568

Fax

(321) 984-7568

NPI assigned

Jun 28, 2013

Last updated

Jun 28, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Elida M Reyes-Kerr

Title

Owner/Administrator

Phone

(321) 984-7568

Specialties & licenses 1

Addresses

Tax ID family

Elida M Reyes-Kerr2 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.

• Elida M. Reyes-Kerr

  dba Glenville Pines ALF

  • Assisted Living Facility
  • Palm Bay, FL
  • NPI 1699114066
  NPD tax ID

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372377600000",
    "number": "1851731236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 STEELE RD SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329095332",
            "telephone_number": "321-984-7568",
            "fax_number": "321-984-7568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 STEELE RD SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329095332",
            "telephone_number": "321-984-7568",
            "fax_number": "321-984-7568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENVILLE PINES ASSISTED LIVING FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-28",
        "last_updated": "2013-06-28",
        "status": "A",
        "authorized_official_last_name": "REYES-KERR",
        "authorized_official_first_name": "ELIDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "321-984-7568",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gift of Faith, LLC Alf
• Tasha Gillet-Green
• Alexander Ginwright
• Wendy Giordan, RD, LD
• Faith Gisondi, MS, LMHC
• Glenville Pines II Assisted Living Facility LLC
• Global Link Consulting Services LLC Dba Loving Hands Home Living
• Glomar Medical Inc.
• Jeanette Marie Gluck, PA-C
• Goelz Enterprises (Prime Physical Therapy)

• Assisted Living Facility in Palm Bay, FL
• Providers in Palm Bay, 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 Jun 28, 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.