NPIMap

Organization Active NPI

Adult Family Home Care, Inc.

  • Adult Care Home Facility
  • Palm Bay, FL
National Provider Identifier
1871836908
Registry record updated Mar 27, 2013
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Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
6905399 Issued in FL
Legal business name
ADULT FAMILY HOME CARE, INC.
Practice address
2052 Syracuse CT NE
Palm Bay, FL 32905-3923
Phone
(321) 951-2887
Fax
(321) 327-5000
NPI assigned
Mar 27, 2013
Last updated
Mar 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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

Authorized official

Name
Ms. Bernice G Laidlaw
Title
Owner/Administrator
Phone
(321) 951-2887

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 6905399 FL Primary

Addresses

Primary practice location

2052 Syracuse CT NE
Palm Bay, FL 32905-3923

Mailing address

2052-54 Syracuse Court
Palm Bay, FL 32905
Phone (321) 951-2887

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1871836908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2052-54 SYRACUSE COURT",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "32905",
            "telephone_number": "321-951-2887",
            "fax_number": "321-327-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2052 SYRACUSE CT NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329053923",
            "telephone_number": "321-951-2887",
            "fax_number": "321-327-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT FAMILY HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-27",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "LAIDLAW",
        "authorized_official_first_name": "BERNICE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "321-951-2887",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6905399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.