MR. DAVID CHRISTOPHER WADE NPI 1184902157

NPI Information

NPI: 1184902157
Provider Name: MR. DAVID CHRISTOPHER WADE
Classification: Assisted Living Facility - 3104A0625X
Entity Type: Individual

Specialization: Assisted Living, Mental Illness

Address:
4623 EBONY ST
ORLANDO, FL
ZIP 32811
Phone: (407) 990-6333
Get Directions

MR. David Christopher Wade is an assisted living and mental illness assisted living facility in Orlando, FL. The provider is 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. MR. David Christopher Wade NPI is 1184902157. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4623 EBONY ST
ORLANDO, FL
ZIP 32811-823
Phone: (407) 990-6333
Fax: (321) 206-4502

The enumeration date for this NPI number is 7/25/2011 and was last updated on 2/10/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	372600000X	Adult Companion				No
2	310400000X	Assisted Living Facility			FLORIDA	No
3	251E00000X	Home Health		007902900	FLORIDA	No
4	251E00000X	Home Health		003905100	FLORIDA	No
5	3104A0625X	Assisted Living Facility	Assisted Living, Mental Illness		FLORIDA	Yes
6	376J00000X	Homemaker		232909	FLORIDA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	007902900	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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