Brevard Alzheimer's Foundation Inc.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

BREVARD ALZHEIMER'S FOUNDATION INC.

Practice address

7951 Ron Beatty Blvd
Micco, FL 32976-7468

Phone

(321) 253-4430

Fax

(321) 253-1993

NPI assigned

Jul 15, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Timothy Victor Timmemann

Title

Executive Director

Phone

(321) 253-4430

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Brevard Alzheimer's Foundation Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Brevard Alzheimer's Foundation Inc.

  dba Joe's Club

  • Adult Day Care Clinic/Center
  • Titusville, FL
  • NPI 1518633569
  NPD tax ID
• Brevard Alzheimer's Foundation, Inc.

  dba Joe's Club

  • Adult Day Care Clinic/Center
  • Melbourne, FL
  • NPI 1174795454
  NPD tax ID
• Brevard Alzheimer's Foundation, Inc.

  dba Joe's Club

  • Non-emergency Medical Transport (VAN)
  • Melbourne, FL
  • NPI 1568887917
  NPD tax ID

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1952973109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4676 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329357103",
            "telephone_number": "321-253-4430",
            "fax_number": "321-253-1993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7951 RON BEATTY BLVD",
            "city": "MICCO",
            "state": "FL",
            "postal_code": "329767468",
            "telephone_number": "321-253-4430",
            "fax_number": "321-253-1993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 S Park Ave",
            "address_purpose": "LOCATION",
            "city": "Titusville",
            "state": "FL",
            "postal_code": "327804000",
            "country_code": "US",
            "telephone_number": "321-253-4430",
            "fax_number": "321-253-1993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BREVARD ALZHEIMER'S FOUNDATION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "TIMMEMANN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "321-253-4430",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010751300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104835401",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Align Physical Therapy, Inc.
• Lori Ellen Bray
• Comfort Chiropractic PA
• Diversified Specialties
• Imi Ola
• Mary Helena Lesperance, PHARMACIST (R.PH.)
• Roberta Jo Miller, APRN

• Adult Day Care Clinic/Center in Micco, FL
• Providers in Micco, FL by specialty
• Adult Day Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.