GLENVILLE PINES II ASSISTED LIVING FACILITY LLC (NPI# 1447756655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447756655 |
| Entity Type | Organization |
| Organization Name | GLENVILLE PINES II ASSISTED LIVING FACILITY LLC |
| Other Organization Name | GLENVILLE PINES II ASSISTED LIVING FACILITY LLC |
| Practice Address |
211 Silver Oak Rd Ne Palm Bay FL 32907-5582 |
| Mailing Address |
1351 Steele Rd Se Palm Bay FL 32909-5332 |
| Practice Telephone | 3218024121 |
| Practice Fax Number | 3219847568 |
| Mailing Telephone | 3212584056 |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2018-04-05 |
| Authorized Official Name | MS. ELIDA M REYES-KERR (ADMINISTRATOR) |
| Authorized Official Telephone | 3212584056 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL12461 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 022322700 | 05 |
| Other Name | Type Code |
|---|---|
| GLENVILLE PINES II ASSISTED LIVING FACILITY LLC | Doing Business As Name - Organization |
| Street Address |
211 SILVER OAK RD NE |
| City | PALM BAY |
| State | FL |
| Zip Code | 32907-5582 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861015109 | Tyreak Albert Mclarty | Behavior Technician | 2180 Julian Ave Nw, Palm Bay, FL 32907 | 2020-05-21 |
| 1871073759 | Jessica Elizabeth Ford | Physical Therapist | 470 Malabar Rd Se Unit 102, Palm Bay, FL 32907 | 2018-08-20 |
| 1598264558 | Corey Williams | Case Management | 1850 Delki St. Nw, Palm Bay, FL 32907 | 2018-02-06 |
| 1386154904 | Lauren Nicole Meek | Social Worker | 550 Malabar Rd Sw Apt 202, Palm Bay, FL 32907 | 2017-10-10 |
| 1679002877 | Kandice Monique Hearns | Physical Therapy Assistant | 175 Ne Villa Nueva Ave, Palm Bay, FL 32907 | 2017-06-09 |
| 1780113076 | Caring Manor LLC | Assisted Living Facility | 1863 Edith St Ne, Palm Bay, FL 32907 | 2017-06-08 |
| 1467992107 | Enrique Martinez | Counselor | 1510 Studley Dr. Nw, Palm Bay, FL 32907 | 2017-02-28 |
| 1144776469 | Stephanie Ann Hoenig | Physical Therapy Assistant | 1155 Malabar Rd Se, Palm Bay, FL 32907 | 2016-08-28 |
| 1124471529 | K & S Tender Care 11 | Assisted Living Facility | 226 Abalone Road Ne, Palm Bay, FL 32907 | 2016-07-20 |
| 1235507781 | Jai Ho LLC | Specialist | 1663 Georgia Street, Suite 400, Palm Bay, FL 32907 | 2015-09-14 |
| Find all providers in zip 32907 | ||||
| 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 |
|---|---|---|---|---|
| 1982205787 | Pd & Sr, L.L.C. | Assisted Living Facility | 730 Frisco St Se, Palm Bay, FL 32909-3711 | 2020-11-06 |
| 1003423294 | Rome's Paradise Assisted Living II | Assisted Living Facility | 564 Delmonico St Ne, Palm Bay, FL 32907-3129 | 2020-09-30 |
| 1447881297 | Shangri-la of Palm Bay Alf, LLC | Assisted Living Facility | 3604 Jupiter Blvd. Se, Palm Bay, FL 32909 | 2020-01-30 |
| 1871136127 | Lucienne Cajuste Delva | Assisted Living Facility | 1246 Harlingen Rd Sw, Palm Bay, FL 32908-7146 | 2019-10-18 |
| 1811483290 | Welcome Home Assisted Living Facility LLC | Assisted Living Facility | 1387 San Cortez Ave Ne, Palm Bay, FL 32907-1118 | 2018-07-09 |
| 1851883706 | Tara Demetria Johnson | Assisted Living Facility | 226 Abalone Rd Nw, Palm Bay, FL 32907-2964 | 2018-06-05 |
| 1437640653 | Hannah's Home LLC | Assisted Living Facility | 997 Lyons Cir Nw, Palm Bay, FL 32907-5911 | 2018-05-23 |
| 1982107678 | Serenity Lifestyle Plus | Assisted Living Facility | 178 Evergreen St Ne, Palm Bay, FL 32907-1905 | 2018-03-09 |
| 1780113076 | Caring Manor LLC | Assisted Living Facility | 1863 Edith St Ne, Palm Bay, FL 32907 | 2017-06-08 |
| 1952836736 | Blue Fountain II Home Care, LLC. | Assisted Living Facility | 1310 Sequoia Rd Nw, Palm Bay, FL 32907-2780 | 2017-04-28 |
| Find all providers in PALM BAY | ||||
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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.