INDEPENDENT LIVING WITH CARE INC. ALF NPI 1679914741

NPI Information

NPI: 1679914741
Provider Name: INDEPENDENT LIVING WITH CARE, INC. ALF

Former Legal Business Name: ALF

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
3165 SW FAMBROUGH ST
PORT ST LUCIE, FL
ZIP 34953
Phone: (772) 878-1010
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INDEPENDENT LIVING WITH CARE, INC. ALF is an assisted living facility in Port St Lucie, FL. The provider is 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. INDEPENDENT LIVING WITH CARE, INC. ALF NPI is 1679914741. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Alf.

The provider's business location address is:

3165 SW FAMBROUGH ST
PORT ST LUCIE, FL
ZIP 34953-541
Phone: (772) 878-1010
Fax: (772) 345-1402

The provider's authorized official is Tisa Forte .
The authorized official title is Owner and has the following contact phone number (772) 878-1010.

The enumeration date for this NPI number is 7/17/2013 and was last updated on 7/17/2013.

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	310400000X	Assisted Living Facility		11368	FLORIDA	Yes

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	000179100	MEDICAID	FLORIDA
2	000585500	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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