CEDAR CREEK AT KINGS BAY, INC (NPI# 1104262302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104262302 |
| Entity Type | Organization |
| Organization Name | CEDAR CREEK AT KINGS BAY, INC |
| Other Organization Name | CEDAR CREEK |
| Practice Address |
231 Nw Hwy 19 Crystal River FL 34428 |
| Practice Telephone | 3525642446 |
| Mailing Telephone | 3525642446 |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2013-05-14 |
| Authorized Official Name | MS. HEATHER STEVENS (ASSISTANT DIRECTOR) |
| Authorized Official Telephone | 3525642446 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL10230 | FL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Cedar Creek | Doing Business As Name - Organization |
| Street Address |
231 NW HWY 19 |
| City | CRYSTAL RIVER |
| State | FL |
| Zip Code | 34428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992129639 | Kady Rae Gonzalez | Pharmacist | 6201 North Suncoast Boulevard, Crystal River, FL 34428 | 2014-02-18 |
| 1558707828 | Lisa Kelly | Occupational Therapist | 8410 North Maple Avenue, Crystal River, FL 34428 | 2013-05-14 |
| 1235479403 | Jericka Sanders | Physical Therapy Assistant | 10105 W Ohio Dr, Crystal River, FL 34428 | 2013-02-25 |
| 1952627788 | Philip A Cenatiempo | Pharmacist | 1801 Nw Hwy 19, Crystal River, FL 34428 | 2010-04-19 |
| 1871816256 | Alexis R Bergan-guzman | Chiropractor | 116 Nw 5th Street, Crystal River, FL 34428 | 2010-03-12 |
| 1679707889 | Elizabeth Davis Mazzeo | Social Worker | 708 Ne 6th St, Crystal River, FL 34428 | 2009-05-04 |
| 1134136583 | Robert Matthew Berger | Anesthesiology | 6201 Suncoast Blvd, C/o Seven Rivers Regional, Crystal River, FL 34428 | 2006-08-01 |
| 1740211879 | K Mart Corp | Pharmacy | 1801 Northwest Hwy 19, Crystal River, FL 34428 | 2006-07-06 |
| 1174566434 | James T Stiles | Nurse Anesthetist, Certified Registered | 257 Ne Crystal St, Crystal River, FL 34428 | 2006-06-14 |
| 1801876065 | Barbara K Ellis | Nurse Practitioner | Crystal River Womens Health Center, 6151 N Suncoast Blvd Ste 1c, Crystal River, FL 34428 | 2006-01-21 |
| Find all providers in zip 34428 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215335708 | Sunshine Gardens/ Crystal River LLC | Assisted Living Facility | 311 Ne 4th Ave, Crystal River, FL 34429-4222 | 2014-12-15 |
| 1750728812 | Crystal Gem Manor | Assisted Living Facility | 10845 W Gem St, Crystal River, FL 34428-6682 | 2013-05-30 |
| 1386094837 | Crystal Gem Manor | Assisted Living Facility | 10845 W Gem St, Crystal River, FL 34428-6682 | 2016-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275372 | Loving Family Senior Care, LLC | Assisted Living Facility | 2323 Nw 34th St, Miami, FL 33142-5307 | 2020-11-08 |
| 1548861230 | Allure A&l Inc | Assisted Living Facility | 13692 Carlton St, Wellington, FL 33414-7748 | 2020-11-08 |
| 1982205787 | Pd & Sr, L.L.C. | Assisted Living Facility | 730 Frisco St Se, Palm Bay, FL 32909-3711 | 2020-11-06 |
| 1982205019 | Cantillo Love & Care LLC | Assisted Living Facility | 1045 W 23rd St, Hialeah, FL 33010-1922 | 2020-11-04 |
| 1194326728 | Bliss Life Residential Care | Assisted Living Facility | 402 Arthur Ave, Lehigh Acres, FL 33936-7412 | 2020-11-02 |
| 1811597404 | Huguette Mortimer Dupont | Assisted Living Facility | 1596 Sw Paar Dr, Port St Lucie, FL 34953-6159 | 2020-11-01 |
| 1750981841 | Senior Living Properties IIi, LLC | Assisted Living Facility | 3791 Old Canoe Creek Rd, Saint Cloud, FL 34769-6630 | 2020-10-28 |
| 1417556028 | 5081 Cambridge LLC | Assisted Living Facility | 5081 Nw Dunn Rd, Fort Pierce, FL 34981-4942 | 2020-10-23 |
| 1134728926 | Pacifica Lauderhill LLC | Assisted Living Facility | 5500 Nw 69th Ave, Lauderhill, FL 33319-7266 | 2020-10-22 |
| 1760081749 | Hsre-ahr Zephyrhills LLC | Assisted Living Facility | 38130 Pretty Pond Road, Zephyrhills, FL 33540 | 2020-10-21 |
| Find all providers with the same taxonomy | ||||
| City | CRYSTAL RIVER |
| Zip Code | 34428 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.