Active NPI
Miss K'S Enrichment Center Inc Dba Campbell'S Landing Assisted Living
- Assisted Living Facility
- Winter Haven, FL
National Provider Identifier
1851998256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- MISS K'S ENRICHMENT CENTER INC DBA CAMPBELL'S LANDING ASSISTED LIVING
- Practice address
- 904 Lake Martha Dr NE
Winter Haven, FL 33881-4278 - Phone
- (863) 207-1743
- Fax
- (863) 875-8023
- NPI assigned
- Oct 8, 2020
- Organization subpart
- Yes
- Parent organization
- MISS K'S ENRICHMENT CENTER INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Miss Katina L Campbell, LPN
- Title
- Administrator
- Phone
- (863) 207-1743
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Primary |
Addresses
Primary practice location
904 Lake Martha Dr NE
Winter Haven, FL 33881-4278
Mailing address
904 Lake Martha Dr NE
Winter Haven, FL 33881-4278
Phone (863) 207-1743
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 107695000 | Medicaid | FL |
Other names 1
- CAMPBELL'S LANDING
National Provider Directory
National Provider Directory- Part of
- Miss K'S Enrichment Center Inc Dba Campbell'S Landing Assisted Living
Locations
904 Lake Martha Dr NE
Winter Haven, FL 33881
Phone (863) 207-1743
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602115200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1602115200000",
"number": "1851998256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "904 LAKE MARTHA DR NE",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338814278",
"telephone_number": "863-207-1743",
"fax_number": "863-875-8023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "904 LAKE MARTHA DR NE",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338814278",
"telephone_number": "863-207-1743",
"fax_number": "863-875-8023"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MISS K'S ENRICHMENT CENTER INC DBA CAMPBELL'S LANDING ASSISTED LIVING",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MISS K'S ENRICHMENT CENTER INC",
"enumeration_date": "2020-10-08",
"last_updated": "2020-10-08",
"certification_date": "2020-10-08",
"status": "A",
"authorized_official_last_name": "CAMPBELL",
"authorized_official_first_name": "KATINA",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "863-207-1743",
"authorized_official_name_prefix": "Miss",
"authorized_official_credential": "LPN"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "107695000",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CAMPBELL'S LANDING",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Winter Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.