LILLITH MORRIS GROUP HOME INC. (NPI# 1700125374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700125374 |
| Entity Type | Organization |
| Organization Name | LILLITH MORRIS GROUP HOME INC. |
| Practice Address |
364 San Ambrosio St Punta Gorda FL 33983-5767 |
| Practice Telephone | 9416230404 |
| Practice Fax Number | 9416230404 |
| Mailing Telephone | 9416230404 |
| Mailing Fax Number | 9416230404 |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2013-02-01 |
| Authorized Official Name | DEBORAH JOSHUA (DIRECTOR) |
| Authorized Official Telephone | 9416230404 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 385HR2060X |
Respite Care Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
10001505 | FL | Respite Care Facility |
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10001505 | FL | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICAID PROVIDER # (DD WAIVER) | 689522196 | 01 |
| Street Address |
364 SAN AMBROSIO ST |
| City | PUNTA GORDA |
| State | FL |
| Zip Code | 33983-5767 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114327244 | Alexandra Fichetti | Counselor | 1196-j Rio De Janeiro. Ave, Punta Gorda, FL 33983 | 2014-08-26 |
| 1164749719 | Larry D. Rand | Physician Assistant | 27289 Voyageur Dr., Punta Gorda, FL 33983 | 2010-04-22 |
| 1912039223 | Wal-mart Stores, Inc. | Technician/Technologist | 375 Kings Highway, Port Charlotte, FL 33983 | 2007-03-12 |
| 1669552360 | Paul Edward Tuma | Pharmacist | 2000 Kings Highway, Port Charlotte, FL 33983 | 2006-10-17 |
| 1013007145 | Amy Louise Houser | Social Worker | 26559 Barraquilla Avenue, Punta Gorda, FL 33983 | 2006-10-12 |
| 1679560262 | Deep Creek Rnc, LLC | Skilled Nursing Facility | 25325 Rampart Blvd, Port Charlotte, FL 33983 | 2005-09-29 |
| 1447677208 | Karen Partridge | Pharmacist | 375 Kings Hwy, Wal-mart Pharmacy 3349, Port Charlotte, FL 33983 | 2014-03-18 |
| 1104261650 | North Port Retirement Centers, Inc. | Assisted Living Facility | 24949 Sandhill Blvd, Punta Gorda, FL 33983 | 2013-05-09 |
| 1194864009 | Petrija Jen Do Pa | Personal Emergency Response Attendant | 24451 Sandhill Blvd, Suite A, Punta Gorda, FL 33983 | 2007-02-06 |
| 1518414994 | Kristen Cuellar | Clinic/Center | 2428 Nuremberg Blvd, Punta Gorda, FL 33983-2609 | 2016-09-02 |
| Find all providers in zip 33983 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568294 | Open Skyes Family Care Home, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5600 Sw 36th St, West Park, FL 33023-6106 | 2020-11-08 |
| 1124628565 | Rachelle Homehealth Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8539 Gate Pkwy W Unit 9134, Jacksonville, FL 32216-1037 | 2020-10-26 |
| 1497368203 | Careola LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3248 Landing Vw, Tavares, FL 32778-2035 | 2020-08-31 |
| 1982218764 | The Home W/ Guiding Hands | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1256 N Florida Ave, Tarpon Springs, FL 34689-2004 | 2020-08-31 |
| 1306459359 | Joy-little Enterprise LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9148 Ridge Blvd, Jacksonville, FL 32208-1265 | 2020-08-28 |
| 1720691082 | Ohana In Home Senior Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 421 W Georgia St, Tallahassee, FL 32301-1011 | 2020-08-26 |
| 1003428467 | Pamella Omelda Odoms-brown | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 541 Shirley Dr., Apopka, FL 32712 | 2020-08-18 |
| 1831700020 | Mikerline Lyns | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10941 Winding Creek Ln, Boca Raton, FL 33428-5664 | 2020-08-12 |
| 1902416993 | Faith Care Center, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3800 Inverrary Blvd Ste 408d, Lauderhill, FL 33319-4359 | 2020-08-04 |
| 1063020188 | Kristine Kaiser Cravener | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1095 Beckman Dr, South Daytona, FL 32119-2499 | 2020-07-14 |
| Find all providers with the same taxonomy | ||||
| City | PUNTA GORDA |
| Zip Code | 33983 |
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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.