Good Samaritan Care Center Alf Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

10381 Issued in FL

Legal business name

GOOD SAMARITAN CARE CENTER ALF INC

Practice address

6 Reston PL
Palm Coast, FL 32164-6605

Phone

(386) 437-6244

Fax

(386) 437-6244

NPI assigned

Apr 11, 2011

Last updated

Apr 11, 2011By 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

Mrs. Dorota Koszyk-Wielgus

Title

Owner

Phone

(386) 437-6244

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302480000000",
    "number": "1932499977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 RESTON PL",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321646605",
            "telephone_number": "386-437-6244",
            "fax_number": "386-437-6244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 RESTON PL",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321646605",
            "telephone_number": "386-437-6244",
            "fax_number": "386-437-6244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN CARE CENTER ALF INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-11",
        "last_updated": "2011-04-11",
        "status": "A",
        "authorized_official_last_name": "KOSZYK-WIELGUS",
        "authorized_official_first_name": "DOROTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-437-6244",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "10381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johanna Gonzalez, RPH
• Luis Enrique Gonzalez, MD
• Maria Gonzalez, FNP-BC
• Melchor Gonzalez, M.D.
• Good Sam's Assisted Living Residence, LLC
• Joanne Goodin
• Julie A Goodwin, MS
• Ann-Marie Gordon Butler, M.A., CCC
• Taylor Gordon
• Brian Stephen Gorski, PTA

• Assisted Living Facility in Palm Coast, FL
• Providers in Palm Coast, 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 11, 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.