NPIMap

Organization Active NPI

Home Sweet Home Alf

  • Assisted Living Facility
  • Palm Coast, FL
National Provider Identifier
1902431067
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
HOME SWEET HOME ALF
Practice address
36 Bronson LN
Palm Coast, FL 32137-8725
Phone
(386) 307-2407
Fax
(386) 302-0289
NPI assigned
Mar 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

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

Authorized official

Name
Christina Rose CarloughNPI 1396382446
Title
Owner
Phone
(386) 307-2407

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

36 Bronson LN
Palm Coast, FL 32137-8725

Mailing address

36 Bronson LN
Palm Coast, FL 32137-8725
Phone (386) 307-2407

Other identifiers 1

IdentifierTypeStateIssuer
104990100MedicaidFL

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL 3863072407
Other URL 3863072407

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585094400000",
    "number": "1902431067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 BRONSON LN",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378725",
            "telephone_number": "386-307-2407",
            "fax_number": "386-302-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 BRONSON LN",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378725",
            "telephone_number": "386-307-2407",
            "fax_number": "386-302-0289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME SWEET HOME ALF",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-10",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A",
        "authorized_official_last_name": "CARLOUGH",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-307-2407"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104990100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "3863072407",
            "affiliation": "N",
            "endpointDescription": "PHONE",
            "address_1": "36 Bronson Ln",
            "city": "Palm Coast",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321378725",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "3863072407",
            "affiliation": "N",
            "endpointDescription": "PHONE",
            "address_1": "36 Bronson Ln",
            "city": "Palm Coast",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321378725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; 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.