Cref3 FSLP Coconut Creek Owner LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CREF3 FSLP COCONUT CREEK OWNER LLC

Practice address

4175 W Sample Rd
Coconut Creek, FL 33073-4456

Phone

(954) 975-6399

Fax

(954) 975-2367

NPI assigned

Apr 7, 2021

Organization subpart

Yes

Parent organization

CREF3 FSLP PORTFOLIO LLCAs reported in NPPES

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

Authorized official

Name

Bryce William Robinson

Title

Sr. Regional Director of Operations

Phone

(239) 938-6414

Specialties & licenses 1

Addresses

Other names 1

• Sonata Coconut Creek Doing business as

Part of

Cref3 FSLP Portfolio LLC

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1942889787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MARKET PLZ FL 42",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941051126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 W SAMPLE RD",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734456",
            "telephone_number": "954-975-6399",
            "fax_number": "954-975-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREF3 FSLP COCONUT CREEK OWNER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CREF3 FSLP PORTFOLIO LLC",
        "enumeration_date": "2021-04-07",
        "last_updated": "2022-03-11",
        "certification_date": "2021-08-30",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "BRYCE",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "SR. REGIONAL DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "239-938-6414"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sonata Coconut Creek",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sonata Coconut Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Coconut Creek, FL
• Providers in Coconut Creek, 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 Mar 11, 2022; 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.