Swan S.P. Enterprises

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

SWAN S.P. ENTERPRISES

Doing business as

PROMISE MANOR WELLCARe

Practice address

45 W 17TH St
Riviera Beach, FL 33404-6121

Phone

(561) 863-7481

NPI assigned

Oct 27, 2014

Organization subpart

Yes

Parent organization

SWAN S P ENTERPRISESAs reported in NPPES

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

Authorized official

Name

Sandra M Cameron

Title

Administrator

Phone

(561) 863-7481

Specialties & licenses 2

Addresses

Other names 1

• PROMISE MANOR WELLCARe Doing business as

Tax ID family

Swan SP Enterprises2 organizations share this tax ID, including this one

Part of

Swan SP Enterprises

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Swan S.P. Enterprises

  dba Promise Manor Wellcare

  • Assisted Living Facility
  • Riviera Beach, FL
  • NPI 1710381736
  NPD tax ID

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

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414368000000",
    "number": "1942605548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 W 17TH ST",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334046121",
            "telephone_number": "561-863-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W 17TH ST",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334046121",
            "telephone_number": "561-863-7481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWAN S.P. ENTERPRISES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SWAN S P ENTERPRISES",
        "enumeration_date": "2014-10-27",
        "last_updated": "2014-10-27",
        "status": "A",
        "authorized_official_last_name": "CAMERON",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "561-863-7481"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROMISE MANOR WELLCARe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sunshine Dialysis Care Centers,Inc.
• Sunshine Healthcare Group, LLC
• Support Services Network, Inc.
• Jannie Sutherland
• Swan S.P. Enterprises (Promise Manor Wellcare)
• Scott Duane Swan, RN
• Karrah Sweetman
• Kate Ann Swett, RKT
• Jerry Scott Swyers, M.D.
• Sandra Jill Symonds

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Riviera Beach, FL
• Providers in Riviera Beach, FL by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; 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.