Glade Garden Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12375 Issued in FL

Legal business name

GLADE GARDEN INC

Practice address

5860 91St Ave N
Pinellas Park, FL 33782-4910

Phone

(727) 258-4537

Fax

(727) 544-2716

NPI assigned

Oct 16, 2013

Organization subpart

No

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

Authorized official

Name

Ena Redzic

Title

Vice President

Phone

(727) 507-1934

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381881600000",
    "number": "1861820540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5860 91ST AVE N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337824910",
            "telephone_number": "727-258-4537",
            "fax_number": "727-544-2716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5860 91ST AVE N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337824910",
            "telephone_number": "727-258-4537",
            "fax_number": "727-544-2716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLADE GARDEN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-10-16",
        "status": "A",
        "authorized_official_last_name": "REDZIC",
        "authorized_official_first_name": "ENA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "727-507-1934"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.