NPIMap

Organization Active NPI

Agency Provider Services for Independence LLC

  • Community/Behavioral Health Agency
  • Palm Bay, FL
National Provider Identifier
1891051132
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
L11000062706 Issued in FL
Legal business name
AGENCY PROVIDER SERVICES FOR INDEPENDENCE LLC
Practice address
1418 Norman St NE
Unit#1
Palm Bay, FL 32907-2267
Phone
(321) 890-7014
Fax
(321) 722-3760
NPI assigned
Apr 11, 2012
Last updated
Apr 11, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2012

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

Authorized official

Name
Deannalynn Cenkner
Title
President/Owner
Phone
(321) 890-7014

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X L11000062706 FL Primary

Addresses

Primary practice location

1418 Norman St NE
Unit#1
Palm Bay, FL 32907-2267

Mailing address

PO Box 101369
Palm Bay, FL 32910-1369
Phone (321) 890-7014

National Provider Directory

National Provider Directory

Locations

1418 Norman St NE
Ste 1
Palm Bay, FL 32907
Phone (321) 890-7014

NPI Registry JSON

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334102400000",
    "number": "1891051132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 101369",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329101369",
            "telephone_number": "321-890-7014",
            "fax_number": "321-722-3760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 NORMAN ST NE",
            "address_2": "UNIT#1",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329072267",
            "telephone_number": "321-890-7014",
            "fax_number": "321-722-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGENCY PROVIDER SERVICES FOR INDEPENDENCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-11",
        "last_updated": "2012-04-11",
        "status": "A",
        "authorized_official_last_name": "CENKNER",
        "authorized_official_first_name": "DEANNALYNN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "321-890-7014"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "L11000062706",
            "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 Apr 11, 2012; 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.