Avalon Assisted Living

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

AL12029 Issued in FL

Legal business name

AVALON ASSISTED LIVING

Practice address

2580 E First St
Fort Myers, FL 33901-2410

Phone

(239) 479-5282

Fax

(239) 479-7781

NPI assigned

Sep 13, 2011

Last updated

Sep 13, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

PEACE OUTLOOK INC.As reported in NPPES

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

Authorized official

Name

Guerdith Michel

Title

Owner/Administrator

Phone

(786) 859-6824

Specialties & licenses 1

Addresses

Part of

Avalon Assisted Living

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1962784215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 E FIRST ST",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339012410",
            "telephone_number": "239-479-5282",
            "fax_number": "239-479-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 E FIRST ST",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339012410",
            "telephone_number": "239-479-5282",
            "fax_number": "239-479-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON ASSISTED LIVING",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEACE OUTLOOK INC.",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "MICHEL",
        "authorized_official_first_name": "GUERDITH",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "786-859-6824"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AL12029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Casey Aunkst, CRNA
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• Autism Services of FL
• Stephanie Autore, APRN
• Avalon Manor Assisted Living Facility LLC
• Danny Juan Avalos, M.D.
• Avid Intellectual Inc.
• Regla Avila Nunez
• Amanda Jane Avila, MD

• Assisted Living Facility (Mental Illness) in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Assisted Living Facility (Mental Illness) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.