Prestige Place Alf LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PRESTIGE PLACE ALF LLC

Practice address

256 Barbarossa Rd NW
Palm Bay, FL 32907-1809

Phone

(954) 632-5788

NPI assigned

Aug 4, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Koren Natalie McKenzie-John

Title

Administrator

Phone

(954) 632-5788

Specialties & licenses 1

Addresses

Tax ID family

Prestige Place Alf LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Prestige Place Alf LLC

  • Assisted Living Facility
  • Palm Bay, FL
  • NPI 1083155568
  NPD tax ID

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659571200000",
    "number": "1962139493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 NW 23RD PL",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330662266",
            "telephone_number": "954-632-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 BARBAROSSA RD NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071809",
            "telephone_number": "954-632-5788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE PLACE ALF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-08-04",
        "certification_date": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MCKENZIE-JOHN",
        "authorized_official_first_name": "KOREN",
        "authorized_official_middle_name": "NATALIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "954-632-5788",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pinkesh B Prajapati, M.D.
• Precision Care Services LLC
• Gillian Press
• Theotis Pressley
• Prestige Place Alf LLC
• Nadine Price
• Prime Movers Rehab, Inc.
• Coralie Prince, RN
• Sharma Jo Privett
• Vikash Priyadarshi, MD

• Assisted Living Facility in Palm Bay, FL
• Providers in Palm Bay, 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 Aug 4, 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.