Adult Home Villa, Inc.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

AL5408 Issued in FL

Legal business name

ADULT HOME VILLA, INC.

Practice address

4760 8TH Ave S
St Petersburg, FL 33711-1810

Phone

(727) 321-7446

NPI assigned

Sep 15, 2008

Last updated

Sep 15, 2008By 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

Esmeralda Manukonda

Title

Administrator

Phone

(727) 321-7446

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1952550915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 8TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337111810",
            "telephone_number": "727-321-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 8TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337111810",
            "telephone_number": "727-321-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT HOME VILLA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-15",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "MANUKONDA",
        "authorized_official_first_name": "ESMERALDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "727-321-7446"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "AL5408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; 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.