Good Ole Days Adult Living Facility LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GOOD OLE DAYS ADULT LIVING FACILITY LLC

Practice address

3913 Trovati Street
Orlando, FL 32839

Phone

(407) 242-3975

NPI assigned

Jun 15, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Kozette KingNPI 1013329952

Title

Owner/Administrator

Phone

(407) 242-3975

Specialties & licenses 1

Addresses

Other names 2

• Good Ole Days ALF Doing business as
• Good Ole Days Adult Living Facility LLC Doing business as

Practitioners 1

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

• Kozette King

  • Assisted Living Facility
  • Orlando, FL
  • NPI 1013329952
  NPD Authorized official

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592179200000",
    "number": "1851916951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3913 TROVATI STREET",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32839",
            "telephone_number": "407-242-3975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3913 TROVATI STREET",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32839",
            "telephone_number": "407-242-3975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD OLE DAYS ADULT LIVING FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-15",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "KOZETTE",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "407-242-3975",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Ole Days ALF",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Good Ole Days Adult Living Facility LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Roberta Gooden, APRN
• Hannah Sinclaire Goodenow

• Assisted Living Facility in Orlando, FL
• Providers in Orlando, 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 15, 2020; 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.