PRY INC (NPI# 1932570165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932570165 |
| Entity Type | Organization |
| Organization Name | PRY INC |
| Other Organization Name | GOOD SAMARITAN RETIREMENT HOME |
| Practice Address |
507 Se 1st Ave Williston FL 32696-2703 |
| Practice Telephone | 3525282722 |
| Practice Fax Number | 4075283003 |
| Mailing Telephone | 3525282722 |
| Mailing Fax Number | 4075283003 |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2015-10-14 |
| Authorized Official Name | HELEN ROMERO (ADMINISTRATOR) |
| Authorized Official Telephone | 4074355548 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Good Samaritan Retirement Home | Doing Business As Name - Organization |
| Street Address |
507 SE 1ST AVE |
| City | WILLISTON |
| State | FL |
| Zip Code | 32696-2703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821344540 | Good Samaritan Retirement Home | Assisted Living Facility | 507 Se 1st Ave, Williston, FL 32696-2703 | 2012-07-31 |
| 1922430354 | Phi 413, Inc Dba Good Samaritan Retirement Home | Assisted Living Facility | 507 Se 1st Ave, Williston, FL 32696-2703 | 2013-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962060939 | Quick Care Med LLC | Non-Pharmacy Dispensing Site | 517 W Noble Ave, Williston, FL 32696 | 2019-06-04 |
| 1346770930 | Michelle Yvette Dempsey | Home Health Aide | 931 Ne 207th Ave, Williston, FL 32696 | 2017-06-15 |
| 1801157185 | Pratibha Lumb | Family Medicine | 630 N. Main Street, Williston, FL 32696 | 2012-06-04 |
| 1821261306 | Raymond T Webber | Dentist | 610 Sw 1st Ave, Williston, FL 32696 | 2008-04-07 |
| 1003912635 | Jeremie Joseph Young | General Practice | 125 Sw 7th Street, Williston, FL 32696 | 2006-09-14 |
| 1073514543 | Kolli Prabhakara Reddy | Family Medicine | 520 Sw 5th Ave, Williston, FL 32696 | 2005-08-09 |
| 1578584884 | Winn Dixie Stores Inc | Durable Medical Equipment & Medical Supplies | 727 W Noble Ave, Williston, FL 32696-1515 | 2006-07-21 |
| 1841631249 | Lawrence C Rush Jr. | Pharmacist | 727 W Noble Ave, Williston, FL 32696-1515 | 2013-07-13 |
| 1952401648 | Teresa Sever | Pharmacist | 727 W Noble Ave, Williston, FL 32696-1515 | 2006-09-23 |
| 1497060784 | Priscilla Smith | Social Worker | 18990 Ne 49th St, Williston, FL 32696-1555 | 2010-08-11 |
| Find all providers in zip 32696 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952910200 | Darielle Shanette Berrian | Assisted Living Facility | 1548 Georgetown Dr, Lakeland, FL 33811 | 2020-07-23 |
| 1003434028 | Carolyn Clanton Alf LLC | Assisted Living Facility | 1146 Hamilton Ave, Jennings, FL 32053-2253 | 2020-07-07 |
| 1356964555 | Cordoba Alf LLC | Assisted Living Facility | 1135 Sw 100th Ct, Miami, FL 33174-2848 | 2020-05-21 |
| 1205461563 | Alegria Alf LLC | Assisted Living Facility | 1150 Sw 103rd Ct, Miami, FL 33174-2759 | 2020-03-06 |
| 1134764368 | Aum Haven LLC | Assisted Living Facility | 2763 Carmel Ct, Kissimmee, FL 34746-3268 | 2019-11-12 |
| 1275180515 | 1161 Cambridge LLC | Assisted Living Facility | 1161 W 2nd St, Riviera Beach, FL 33404-7627 | 2019-08-21 |
| 1386291623 | Cambridge 13 LLC | Assisted Living Facility | 1560 W 13th St, Riviera Beach, FL 33404-6521 | 2019-08-21 |
| 1851948418 | 3411 Ave Cambridge LLC | Assisted Living Facility | 3411 Avenue H E, Riviera Beach, FL 33404-2101 | 2019-08-19 |
| 1326694308 | W 2nd Cambridge LLC | Assisted Living Facility | 570 W 2nd St, Riviera Beach, FL 33404-7616 | 2019-08-14 |
| 1154976512 | Quality Health Care of Florida.llc | Assisted Living Facility | 1250 Nw 122nd Ave, Plantation, FL 33323-2420 | 2019-08-02 |
| 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.