Our Home at Beacon Hill BSLC LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

OUR HOME AT BEACON HILL BSLC LLC

Practice address

141 Kaelyn LN
Port St Joe, FL 32456-6180

Phone

(850) 647-4000

Fax

(850) 647-4004

NPI assigned

Apr 17, 2015

Last updated

Apr 17, 2015By 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

Liza Rojas

Title

Manager

Phone

(941) 809-6147

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1429228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429228800000",
    "number": "1902293988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 KAELYN LN",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324566180",
            "telephone_number": "850-647-4000",
            "fax_number": "850-647-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 KAELYN LN",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324566180",
            "telephone_number": "850-647-4000",
            "fax_number": "850-647-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR HOME AT BEACON HILL BSLC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-17",
        "last_updated": "2015-04-17",
        "status": "A",
        "authorized_official_last_name": "ROJAS",
        "authorized_official_first_name": "LIZA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "941-809-6147"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004659700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Marlene Nance, LCSW
• Richard Michael Nestrud, M.D.
• New Horizon Primary Care, LLC
• David Joseph Newton, MD
• North Florida Surgeons, PA (NFS Northwest Florida Spine, LLC)
• Pancare of Florida, Inc (PanCare Rx Port St. Joe)
• Pancare of Florida, Inc
• Pancare of Florida, Inc
• Richard Petch, ARNP
• Pharmacy Investment Coordinators Inc (Buy Rite Drugs)

• Assisted Living Facility in Port St Joe, FL
• Providers in Port St Joe, 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 17, 2015; 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.