Florida Senior Care Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

SW6243 Issued in FL

Legal business name

FLORIDA SENIOR CARE SERVICES, LLC

Practice address

5910 Carriage Lake CT
Vero Beach, FL 32968-9476

Phone

(772) 559-8673

Fax

(772) 564-8719

NPI assigned

Jan 14, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Jerry Lloyd Tackett, M.ED., BA, BS, AAMS.NPI 1649496399

Title

VP Business Development

Phone

(772) 559-8673

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerry Lloyd Tackett, IMHC

  • Mental Health Counselor
  • Vero Beach, FL
  • NPI 1649496399
  NPD (past) Authorized official

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1982880688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 691114",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329691114",
            "telephone_number": "772-559-8673",
            "fax_number": "772-564-8719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5910 CARRIAGE LAKE CT",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329689476",
            "telephone_number": "772-559-8673",
            "fax_number": "772-564-8719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA SENIOR CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-14",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "TACKETT",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "LLOYD",
        "authorized_official_title_or_position": "VP BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "772-559-8673",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.ED., BA, BS, AAMS."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "FL",
            "license": "SW6243",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "SW6243",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "SW6243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Florida Physical Therapy & Occupational Therapy LLC
• Florida Respiratory-St Lucie Inc
• Florida Woman Care of Indian River County, LLC
• Sharon Flowers McKenzie
• Valli Jo Flynn, APRN
• Amy Elizabeth Fodor, LCSW
• Angelo A Fodor, PHARMD

• Community/Behavioral Health Agency in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.