OCAMELOT DBA BROOKS MANOR ALF (NPI# 1427365402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427365402 |
| Entity Type | Organization |
| Organization Name | OCAMELOT DBA BROOKS MANOR ALF |
| Practice Address |
2043 Se Watercrest St Port St Lucie FL 34984-4768 |
| Practice Telephone | 7728782364 |
| Practice Fax Number | 7728730200 |
| Mailing Telephone | 7728782364 |
| Mailing Fax Number | 7728730200 |
| Enumeration Date | 2010-09-11 |
| Last Update Date | 2010-09-11 |
| Authorized Official Name | MRS. SABITRI PERSAUD (ADMINISTRATOR) |
| Authorized Official Telephone | 7728782364 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL11748 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 002075100 | 05 |
| Street Address |
2043 SE WATERCREST ST |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34984-4768 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700426053 | Alyssa Raudebaugh-jackson | Behavior Technician | 247 Sw Port St. Lucie Blvd, Port St. Lucie, FL 34984 | 2020-01-14 |
| 1033680830 | Aaron Schamback, Dmd, Pa | Dentist | 155 Sw Port Saint Lucie Blvd, Suite #101, Port Saint Lucie, FL 34984 | 2018-12-06 |
| 1407343361 | St. Lucie Hope Gardens LLC | Assisted Living Facility | 337 Sw Grimaldo Teraace, Port Saint Lucie, FL 34984 | 2018-04-17 |
| 1205353091 | Rachelle Renae Tetreault | Acupuncturist | 451 S.e. Thanksgiiving Avenue, Port St. Lucie, FL 34984 | 2017-08-23 |
| 1598141913 | Unity Recovery Center, Inc | Substance Abuse Rehabilitation Facility | 710 Sw Port St Lucie Blvd, Port St Lucie, FL 34984 | 2015-08-07 |
| 1518201136 | Kerline Dimanche | Physical Therapy Assistant | 461 Se Lancaster Aveune, Port Saint Lucie, FL 34984 | 2012-11-20 |
| 1063776979 | Unity Recovery Center, Inc | Substance Abuse Rehabilitation Facility | 208 Sw Port St Lucie Blvd, Port St Lucie, FL 34984 | 2012-06-26 |
| 1851655849 | Unity Recovery Center, Inc | Substance Abuse Rehabilitation Facility | 1240 Us Highway 1, Suite 200, North Palm Beach, FL 34984 | 2012-06-25 |
| 1003179003 | Judith Wray | Pharmacist | 281 Sw Port St. Lucie Blvd, Port St. Lucie, FL 34984 | 2012-06-25 |
| 1285925446 | Cindy Leahy | Specialist | 2181 Sw Bayshore Blvd, Port St Lucie, FL 34984 | 2011-04-22 |
| Find all providers in zip 34984 | ||||
| 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 |
|---|---|---|---|---|
| 1811597404 | Huguette Mortimer Dupont | Assisted Living Facility | 1596 Sw Paar Dr, Port St Lucie, FL 34953-6159 | 2020-11-01 |
| 1952947228 | Savorah Alf II | Assisted Living Facility | 2369 Sw Fern Cir, Port St Lucie, FL 34953-2951 | 2019-11-21 |
| 1598224669 | Blessings Assisted Living | Assisted Living Facility | 2449 Sw Humber Ct, Port St Lucie, FL 34953-2133 | 2019-03-18 |
| 1427517762 | Springfield Gardens Group Home | Assisted Living Facility | 443 Sw Homeland Rd, Port St Lucie, FL 34953-6208 | 2019-03-17 |
| 1285104463 | Caring Assisted Living, LLC | Assisted Living Facility | 2588 Sw Grotto Cir, Port St Lucie, FL 34953-2926 | 2018-11-29 |
| 1760967590 | Angel of Light Assisted Living Facility, LLC | Assisted Living Facility | 613 Sw Homeland Rd, Port St Lucie, FL 34953-6263 | 2018-09-27 |
| 1386121333 | For His Glory Alf LLC. | Assisted Living Facility | 322 Sw South Quick Circle, Port St Lucie, FL 34953 | 2018-07-23 |
| 1033696232 | New Dimension Family Care Inc. | Assisted Living Facility | 849 Sw Hamberland Ave, Port St Lucie, FL 34953-5629 | 2018-07-20 |
| 1659857001 | Heavenly Adult Care LLC | Assisted Living Facility | 3934 Sw Kakopo St, Port St Lucie, FL 34953-3631 | 2018-07-18 |
| 1336635796 | Avalon Family Resort Assisted Living | Assisted Living Facility | 160 Sw Saratoga Ave, Port St Lucie, FL 34953-5977 | 2018-07-09 |
| Find all providers in PORT ST LUCIE | ||||
| City | PORT ST LUCIE |
| Zip Code | 34984 |
Please comment or provide details below to improve the information on OCAMELOT DBA BROOKS MANOR ALF.
| 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.