NPIMap

Organization Active NPI

Marydale Inc

Doing business as Maryland Manor

  • Assisted Living Facility
  • Hudson, FL
National Provider Identifier
1982091518
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL7165 Issued in FL
Legal business name
MARYDALE INC
Doing business as
Maryland Manor
Practice address
7632 Maryland Ave
Hudson, FL 34667-3261
Phone
(727) 642-6900
NPI assigned
Apr 21, 2015
Last updated
Apr 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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

Authorized official

Name
Mr. Bing Santiano
Title
Administrator
Phone
(727) 642-6900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL7165 FL Primary

Addresses

Primary practice location

7632 Maryland Ave
Hudson, FL 34667-3261

Mailing address

7632 Maryland Ave
Hudson, FL 34667-3261
Phone (727) 642-6900

Other names 1

  • Maryland Manor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Marydale Inc2 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.

NPI Registry JSON

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429574400000",
    "number": "1982091518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7632 MARYLAND AVE",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346673261",
            "telephone_number": "727-642-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7632 MARYLAND AVE",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346673261",
            "telephone_number": "727-642-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYDALE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-21",
        "last_updated": "2015-04-21",
        "status": "A",
        "authorized_official_last_name": "SANTIANO",
        "authorized_official_first_name": "BING",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "727-642-6900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL7165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maryland Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hudson, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; 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.