Organization Active NPI

Miami Gardens Manor, Inc.

  • Assisted Living Facility
  • Miami Gardens, FL
National Provider Identifier
1922305200
Registry record updated Feb 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL11092 Issued in FL
Legal business name
MIAMI GARDENS MANOR, INC.
Practice address
915 NW 175TH St
Miami Gardens, FL 33169-4613
Phone
(954) 815-8171
NPI assigned
Feb 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2011

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

Authorized official

Name
Novelette Beharie- Thomas
Title
Owner/Administrator
Phone
(954) 815-8171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL11092 FL Primary

Addresses

Primary practice location

915 NW 175TH St
Miami Gardens, FL 33169-4613

Mailing address

915 NW 175TH St
Miami Gardens, FL 33169-4613
Phone (954) 815-8171

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": "1298332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298332800000",
    "number": "1922305200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 NW 175TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331694613",
            "telephone_number": "954-815-8171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 NW 175TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331694613",
            "telephone_number": "954-815-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIAMI GARDENS MANOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-22",
        "last_updated": "2011-02-22",
        "status": "A",
        "authorized_official_last_name": "BEHARIE- THOMAS",
        "authorized_official_first_name": "NOVELETTE",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "954-815-8171"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL11092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2011; 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.