Superior Living 'LLC'

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SUPERIOR LIVING 'LLC'

Practice address

496 Southeast Verada
Port St Lucie, FL 34983

Phone

(772) 940-6771

NPI assigned

May 18, 2017

Organization subpart

No

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

Authorized official

Name

Letitia Shantel Knowles, RN

Title

Owner/Administrator

Phone

(772) 940-6771

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495411200000",
    "number": "1922535137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 SW DUNCAN TERR.",
            "city": "PSL",
            "state": "FL",
            "postal_code": "34953",
            "telephone_number": "772-940-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 SOUTHEAST VERADA",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "34983",
            "telephone_number": "772-940-6771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR LIVING 'LLC'",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-18",
        "last_updated": "2017-05-22",
        "status": "A",
        "authorized_official_last_name": "KNOWLES",
        "authorized_official_first_name": "LETITIA",
        "authorized_official_middle_name": "SHANTEL",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "772-940-6771",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "RN9395717",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Port St Lucie, FL
• Providers in Port St Lucie, 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 May 22, 2017; 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.