NPIMap

Organization Active NPI

Ellie'S Alf of Eustis

  • Assisted Living Facility
  • Eustis, FL
National Provider Identifier
1962921585
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
6622
Legal business name
ELLIE'S ALF OF EUSTIS
Practice address
907 E Orange Ave
Eustis, FL 32726-6249
Phone
(954) 881-3703
Fax
(352) 357-2375
NPI assigned
Sep 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Gena Ackbersingh
Title
Administrator
Phone
(954) 881-3703

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 6622 Primary

Addresses

Primary practice location

907 E Orange Ave
Eustis, FL 32726-6249

Mailing address

907 E Orange Ave
Eustis, FL 32726-6249
Phone (954) 881-3703

Other names 1

  • Henderson House Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1962921585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 E ORANGE AVE",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266249",
            "telephone_number": "954-881-3703",
            "fax_number": "352-357-2375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 E ORANGE AVE",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266249",
            "telephone_number": "954-881-3703",
            "fax_number": "352-357-2375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIE'S ALF OF EUSTIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-14",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ACKBERSINGH",
        "authorized_official_first_name": "GENA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "954-881-3703",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": "6622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henderson House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eustis, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.