PALM COAST ALF MANAGEMENT LLC (NPI# 1922617505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922617505 |
| Entity Type | Organization |
| Organization Name | PALM COAST ALF MANAGEMENT LLC |
| Practice Address |
3830 Old Kings Road Palm Coast FL 32137 |
| Mailing Address |
269 Kipling Ct Lake Mary FL 32746-4124 |
| Practice Telephone | 3863075445 |
| Mailing Telephone | 4072020046 |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2020-07-29 |
| Authorized Official Name | MR. DERICK WAYNE DEETER (MANAGER) |
| Authorized Official Telephone | 4072020046 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Gold Choice Palm Coast | Doing Business As Name - Organization |
| Street Address |
3830 OLD KINGS ROAD |
| City | PALM COAST |
| State | FL |
| Zip Code | 32137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093324964 | Akilah Collins | Behavior Technician | 515 Palm Coast Pwky Sw, Suite 6, Palm Coast, FL 32137 | 2020-07-27 |
| 1750929477 | Jeanette Ann Stevens | Technician | 1 Lema Place, Palm Coast, FL 32137 | 2019-12-12 |
| 1649816919 | Patrick Meyer | Occupational Therapy Assistant | 9 Pine Cone Drive, Palm Coast, Palm Coast, FL 32137 | 2019-11-21 |
| 1689230385 | Coastal Care Medical Transport | Non-emergency Medical Transport (VAN) | #2b, 1 Hargrove Grde, Palm Coast, FL 32137 | 2019-05-17 |
| 1407357437 | Palm Coast Counseling, LLC | Counselor | 1 Hargrove Grade, Ste B-1, Palm Coast, FL 32137 | 2018-02-25 |
| 1679081459 | Lance J Langston | Behavior Technician | 2 Crosstie Ct, Palm Coast, FL 32137 | 2018-01-16 |
| 1407360712 | Hanna Mercedes Brown | Behavior Technician | 515 Palm Coast Pkwy, Suite 6/7, Palm Coast, FL 32137 | 2017-11-22 |
| 1760994511 | Sophia's Choice Hands That Help, LLC | Custodial Care Facility | 119 Bud Hollow Dr, Palm Coast, FL 32137 | 2017-11-02 |
| 1922543255 | Megan Katherine Dickerson | Physical Therapist | 250 Palm Coast Pkwy Ne Unit 209a, Palm Coast, FL 32137 | 2016-12-22 |
| 1841732112 | Jessica Alysse Santos Cogo | Chiropractor | 9 Palm Harbor Village Way Ste D, Palm Coast, FL 32137 | 2016-11-17 |
| Find all providers in zip 32137 | ||||
| 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 |
|---|---|---|---|---|
| 1447747670 | M H Tender Care Inc. | Assisted Living Facility | 36 Bronson Ln, Palm Coast, FL 32137-8725 | 2018-04-13 |
| 1720585003 | M H Tender Care Inc. | Assisted Living Facility | 9 Ponderosa Ln, Palm Coast, FL 32164-4921 | 2018-04-12 |
| 1376040741 | Murna M Hanson | Assisted Living Facility | 29 Prince John Ln, Palm Coast, FL 32164-7165 | 2018-04-11 |
| 1205349800 | Tigris Rivers | Assisted Living Facility | 10 Riddle Dr, Palm Coast, FL 32164-6525 | 2017-11-06 |
| 1538604764 | Good Sam's Assisted Living Residence, LLC | Assisted Living Facility | 1 Pebble Wood Ln, Palm Coast, FL 32164-7491 | 2016-12-26 |
| 1639548621 | Capstone Healthcare,l.l.c | Assisted Living Facility | 19 Port Echo Ln, Palm Coast, FL 32164-6733 | 2015-09-19 |
| 1265833131 | Pampered Parents, Alf, Inc. | Assisted Living Facility | 6 Seton Ct, Palm Coast, FL 32164-4430 | 2014-09-10 |
| 1457773780 | Southern Breeze Living, LLC | Assisted Living Facility | 18 Woodward Ln, Palm Coast, FL 32164-3103 | 2014-01-06 |
| 1336560937 | Cr Loving Care, Inc. | Assisted Living Facility | 74 Prince Michael Ln, Palm Coast, FL 32164-7154 | 2013-12-27 |
| 1033540984 | M H Tender Care Inc. | Assisted Living Facility | 9 Wainwood Pl, Palm Coast, FL 32164-7674 | 2013-12-03 |
| Find all providers in PALM COAST | ||||
| City | PALM COAST |
| Zip Code | 32137 |
Please comment or provide details below to improve the information on PALM COAST ALF MANAGEMENT LLC.
| 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.