KIST ALF, INC (NPI# 1013345883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013345883 |
| Entity Type | Organization |
| Organization Name | KIST ALF, INC |
| Practice Address |
1516 Carmen Avenue Daytona Beach FL 32117 |
| Practice Telephone | 3862399774 |
| Mailing Telephone | 3862399774 |
| Enumeration Date | 2013-10-14 |
| Last Update Date | 2013-10-14 |
| Authorized Official Name | MRS. SHARON KIST (OWNER) |
| Authorized Official Telephone | 3865661020 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL9802 | FL | Nursing & Custodial Care Facilities |
| Street Address |
1516 CARMEN AVENUE |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992350409 | Erin Selfridge | Pharmacist | 1500 Beville Rd #300, Daytona Beach, FL 32117 | 2019-08-02 |
| 1881185494 | Wellspring Health, LLC | Chiropractor | 701 Ridgewood Ave, Holly Hills, FL 32117 | 2018-05-21 |
| 1780172791 | L & L Db, LLC | Clinic/Center | 1540 Cornerstone Blvd, Suite 100, Daytona Beach, FL 32117 | 2018-04-25 |
| 1154837789 | Brittany Nikolow | Nurse Practitioner | 1717 N. Clyde Morris, Daytona Beach, FL 32117 | 2017-12-19 |
| 1205356946 | Alejandro Andre Pabon Rodriguez | Nurse Anesthetist, Certified Registered | Florida Hospital Memorial Medical Center, 301 Memorial Medical Parkway, Daytona Beach, FL 32117 | 2017-06-23 |
| 1316492135 | Ann Van Herck | Physical Therapist | 1901 Mason Ave Ste 105, Daytona Beach, FL 32117 | 2016-08-22 |
| 1952784779 | Kathryn Brenna Copley | Nurse Practitioner | 1890 Lpga Blvd., Daytona Beach, FL 32117 | 2015-06-30 |
| 1053719559 | Alicia Graham | Case Manager/Care Coordinator | 1570 Megan Bay Circle, Holly Hill, FL 32117 | 2014-12-15 |
| 1578974440 | Halifax Senior Care Inc | Clinic/Center | 1515 Ridgewood Ave, Suite B, Holly Hill, FL 32117 | 2014-05-14 |
| 1699108795 | Tailor-made Medical Solutions | Nursing Care | 1891 N. Clyde Morris Blvd, Ste 100, Daytona Beach, FL 32117 | 2013-08-13 |
| Find all providers in zip 32117 | ||||
| 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 |
|---|---|---|---|---|
| 1104436443 | Baywood Meadows Assisted Living | Assisted Living Facility | 105 Baywood Dr, Daytona Beach, FL 32117-4601 | 2020-08-02 |
| 1912323056 | Editha Ignacio | Assisted Living Facility | 1636 E Shangri La Dr, Daytona Beach, FL 32119-1520 | 2014-03-13 |
| 1194140509 | Senior Life LLC | Assisted Living Facility | 619 Orange Ave, Daytona Beach, FL 32114-4786 | 2014-02-20 |
| 1275957276 | Isabelle Berber | Assisted Living Facility | 1249 Suwanee Rd, Daytona Beach, FL 32114-5918 | 2014-02-11 |
| 1942624366 | Justina Threadgill | Assisted Living Facility | 1312 Mardrake Rd, Daytona Beach, FL 32114-5940 | 2014-02-05 |
| 1912337866 | Compassion In Healthcare Inc | Assisted Living Facility | 700 Beville Rd, Daytona Beach, FL 32114-5924 | 2013-11-13 |
| 1306180724 | Lakewood Park Investments Inc | Assisted Living Facility | 1220 Jimmy Ann Dr, Daytona Beach, FL 32117-3818 | 2012-11-26 |
| 1316281215 | Selah - Forest Lake Manor, LLC | Assisted Living Facility | 252 Forest Lake Blvd, Daytona Beach, FL 32119-8106 | 2012-11-15 |
| 1699036285 | Shady Oaks Rest Home Inc. | Assisted Living Facility | 1208 Kennedy Rd, Daytona Beach, FL 32117 | 2012-05-31 |
| 1437266350 | The Place At Daytona Beach, Inc. | Assisted Living Facility | 570 National Health Care Dr, Daytona Beach, FL 32114-1494 | 2006-08-24 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32117 |
Please comment or provide details below to improve the information on KIST ALF, INC.
| 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.