Forest Spring Retirement Residence, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10921 Issued in FL

Legal business name

FOREST SPRING RETIREMENT RESIDENCE, INC

Practice address

7512 SW 5TH St
North Lauderdale, FL 33068-1333

Phone

(954) 724-2038

NPI assigned

Apr 19, 2013

Last updated

Apr 19, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sophia Stupart

Title

Owner

Phone

(954) 548-9090

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366329600000",
    "number": "1902240021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7512 SW 5TH ST",
            "city": "NORTH LAUDERDALE",
            "state": "FL",
            "postal_code": "330681333",
            "telephone_number": "954-724-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7512 SW 5TH ST",
            "city": "NORTH LAUDERDALE",
            "state": "FL",
            "postal_code": "330681333",
            "telephone_number": "954-724-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST SPRING RETIREMENT RESIDENCE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-19",
        "last_updated": "2013-04-19",
        "status": "A",
        "authorized_official_last_name": "STUPART",
        "authorized_official_first_name": "SOPHIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-548-9090"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Courtney Jene Frost, PT, DPT
• Shanreka A Gard
• Sherida Gayle, LMFT

• Assisted Living Facility in North Lauderdale, FL
• Providers in North Lauderdale, 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 Apr 19, 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.