IMMACULATE ADULT DAY CARE LLC (NPI# 1144876327) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144876327 |
| Entity Type | Organization |
| Organization Name | IMMACULATE ADULT DAY CARE LLC |
| Other Organization Name | SENIOR CARE OF BREVARD |
| Practice Address |
234 Willard St Ste A Cocoa FL 32922-7984 |
| Practice Telephone | 3216319014 |
| Practice Fax Number | 3216318010 |
| Mailing Telephone | 3216319014 |
| Mailing Fax Number | 3216318010 |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2020-01-27 |
| Authorized Official Name | MS. JOY RUTHERFORD (CEO) |
| Authorized Official Telephone | 3216319014 |
| Authorized Official Credential | APRN,MSN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 311500000X | Alzheimer Center (Dementia Center) | Nursing & Custodial Care Facilities | ||
| Y | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 105066100 | 05 |
| Other Name | Type Code |
|---|---|
| Senior Care of Brevard | Doing Business As Name - Organization |
| Street Address |
234 WILLARD ST STE A |
| City | COCOA |
| State | FL |
| Zip Code | 32922-7984 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447884473 | Joy Rutherford | Nurse Practitioner | 234 Willard St Ste A, Cocoa, FL 32922-7984 | 2020-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396260030 | Shacarra Danielle Pouncey | Behavioral Analyst | 453 King Street, Cocoa, FL 32922 | 2017-08-03 |
| 1851815849 | El-shaddai & Sons Maintenance LLC | Non-emergency Medical Transport (VAN) | 209 Factory St, Cocoa, FL 32922 | 2017-08-01 |
| 1891241949 | Stephanie B Duncan Kidwell | Developmental Therapist | 453 Cocoa St., Cocoa, FL 32922 | 2016-08-29 |
| 1861859746 | Ruth Ellis | Counselor | 7 N. Cocoa Blvd., Cocoa, FL 32922 | 2016-01-22 |
| 1528334109 | Cynthia Vicky Doyle | Counselor | 1407 Dixon Blvd., Cocoa, FL 32922 | 2012-03-28 |
| 1205156106 | Rhea Lucette Gibbs | Social Worker | 317 Riveredge B Lvd., Suite 104, Cocoa, FL 32922 | 2010-06-03 |
| 1871816439 | Suzanne P. Jasper-demarco | Behavioral Analyst | 550 Saint Johns St, Cocoa, FL 32922 | 2010-03-10 |
| 1023223294 | Loraine Catalano Schuh | Social Worker | 317 Riveredge Blvd, Suite 104, Cocoa, FL 32922 | 2007-05-11 |
| 1679795546 | Amber Elizabeth Bell | Counselor | Kidspeace, 633-b Brevard Avenue, Cocoa, FL 32922 | 2007-05-02 |
| 1154549343 | Venkata Naga Laxmi Cheedhella | Pharmacist | 1451 Dixon Blvd, Cocoa, FL 32922 | 2007-04-23 |
| Find all providers in zip 32922 | ||||
| Taxonomy Code | 261QA0600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Day Care |
| Definition to come... |
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|---|---|---|---|---|
| 1316548019 | Renacer Adult Day Care LLC | Clinic/Center | 1968 Nw 7th St, Miami, FL 33125-3411 | 2020-11-08 |
| 1972104164 | El Prado Senior Club Corp | Clinic/Center | 1800 W 68th St Ste 101-105, Hialeah, FL 33014-4404 | 2020-11-04 |
| 1679174924 | Divine Leisure & Activity Center,llc | Clinic/Center | 6500 W 4th Ave Ste 26, Hialeah, FL 33012-6606 | 2020-11-03 |
| 1659972917 | Hope Family Adult Day Care Center LLC | Clinic/Center | 204 E Mckenzie St Unit A, Punta Gorda, FL 33950-6069 | 2020-11-03 |
| 1487254157 | Universal Adult Day Care Inc | Clinic/Center | 10174 W Flagler St, Miami, FL 33174-1830 | 2020-10-30 |
| 1801496583 | Penate Adult Daycare 3 LLC | Clinic/Center | 18950 Sw 106th Ave Ste 115, Cutler Bay, FL 33157-7699 | 2020-10-30 |
| 1568061885 | All Smiles Senior & Adult Day Care Center | Clinic/Center | 1072 E Venice Ave, Venice, FL 34285-7162 | 2020-10-19 |
| 1679171326 | Constance Pierre Louis Gauthier | Clinic/Center | 812 Dogwood Rd, West Palm Beach, FL 33409-6141 | 2020-10-14 |
| 1871190157 | Shenna Michelle Clyburn | Clinic/Center | 3112 Delaware Ave, Fort Pierce, FL 34947-3531 | 2020-10-08 |
| 1669079323 | Hemo Medika Care LLC | Clinic/Center | 3425 10th St N Ste 1, Naples, FL 34103-3866 | 2020-10-06 |
| Find all providers with the same taxonomy | ||||
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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.