Coral Springs Country Club for Seniors, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10582 Issued in FL

Legal business name

CORAL SPRINGS COUNTRY CLUB FOR SENIORS, INC.

Practice address

2903 NW 115TH Ter
Coral Springs, FL 33065-3439

Phone

(954) 839-4791

NPI assigned

Apr 23, 2013

Organization subpart

No

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

Authorized official

Name

Petrinea A Mattis, MBA/HCM

Title

Administrator

Phone

(954) 839-4791

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366675200000",
    "number": "1932543782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2903 NW 115TH TER",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653439",
            "telephone_number": "954-839-4791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2903 NW 115TH TER",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653439",
            "telephone_number": "954-839-4791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAL SPRINGS COUNTRY CLUB FOR SENIORS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-23",
        "last_updated": "2013-04-23",
        "status": "A",
        "authorized_official_last_name": "MATTIS",
        "authorized_official_first_name": "PETRINEA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "954-839-4791",
        "authorized_official_credential": "MBA/HCM"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Coral Springs Ambulatory Surgery Center LLC (Coral Springs Surgical Center)
• Coral Springs Behavioral Services LLC
• Coral Springs Center for Medicine & Surgery of the Foot & Leg Inc
• Coral Springs Dental
• Coral Springs Dental Associates (Coral Springs Premier Dentists)
• Coral Springs Dental Group, LLC
• Coral Springs Ekg Readers Inc
• Coral Springs Family Dental Associates

• Assisted Living Facility in Coral Springs, FL
• Providers in Coral Springs, 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 23, 2013; 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.