Thonotosassa, FL Opco, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

THONOTOSASSA, FL OPCO, LLC

Practice address

12006 McIntosh Rd
Thonotosassa, FL 33592-3838

Phone

(813) 986-7900

NPI assigned

Jan 25, 2016

Organization subpart

No

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

Authorized official

Name

Isaac Dole

Title

Manager

Phone

(312) 724-8950

Specialties & licenses 1

Addresses

Other names 1

• Stone Ledge Manor Doing business as

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453680000000",
    "number": "1982061644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 N CAMPBELL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475203",
            "telephone_number": "312-724-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12006 MCINTOSH RD",
            "city": "THONOTOSASSA",
            "state": "FL",
            "postal_code": "335923838",
            "telephone_number": "813-986-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THONOTOSASSA, FL OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-01-25",
        "status": "A",
        "authorized_official_last_name": "DOLE",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "312-724-8950"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stone Ledge Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aurora Santos
• Delaney Ann Stanton
• Stone Ledge Manor
• Succes Home Care Services
• Suncoast Community Health Centers, Inc
• Venice Gardens LLC
• Robert Ponder Vereen
• Jorge J Villalba, M.D.
• Paulette C Walker-Slater
• West Florida Health Home Infusion LLC

• Assisted Living Facility in Thonotosassa, FL
• Providers in Thonotosassa, 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 Jan 25, 2016; 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.