SUMMERVILLE AT OAK PARK, LLC (NPI# 1023227865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023227865 |
| Entity Type | Organization |
| Organization Name | SUMMERVILLE AT OAK PARK, LLC |
| Other Organization Name | BROOKDALE CLERMONT |
| Practice Address |
650 East Minnehaha Avenue Clermont FL 34711 |
| Mailing Address |
6737 W Washington St Ste 2300 Milwaukee WI 53214-5650 |
| Practice Telephone | 3522410844 |
| Practice Fax Number | 3522419088 |
| Mailing Telephone | 4149185000 |
| Mailing Fax Number | 2063014500 |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2016-06-13 |
| Authorized Official Name | BRYAN RICHARDSON (EVP, CHIEF ADMIN. OFFICER) |
| Authorized Official Telephone | 6155648131 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL9139 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 0111484-00 | 05 |
| Other Name | Type Code |
|---|---|
| Brookdale Clermont | Doing Business As Name - Organization |
| Street Address |
650 EAST MINNEHAHA AVENUE |
| City | CLERMONT |
| State | FL |
| Zip Code | 34711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316546344 | Latricia Richards-smith | Nurse Practitioner | 3301 Hancock Rd, Clermont, FL 34711 | 2020-10-21 |
| 1073130399 | Marissa Johnston | Behavioral Analyst | 355 Citrus Tower Blvd Ste 112, Clermont, FL 34711 | 2020-07-02 |
| 1649839432 | New Foundations Aba Therapy, LLC | Community/Behavioral Health | 4327 S Hwy 27 #176 Clermont, Clermont, FL 34711 | 2019-06-06 |
| 1275006504 | Innovative Medical Management Solutions LLC | Skilled Nursing Facility | 1775 Hooks Street, Clermont, FL 34711 | 2019-01-09 |
| 1851867766 | Chantal P Baptiste | Nurse Practitioner | 2040 Oakley Seaver Dr Ste 300, Clermont, FL 34711 | 2018-10-17 |
| 1346739539 | Jennifer Brennan | Behavior Technician | 365 Citrus Tower Blvd Bldg Ste 106, Clermont, FL 34711 | 2018-05-03 |
| 1689163966 | Chelsea Strickland | Physical Therapy Assistant | 10037 Stockbridge St, Clermont, FL 34711 | 2018-05-02 |
| 1316448921 | Dana Renee Ottalagano | Counselor | 1635 E Highway 50 Ste 204, Clermont, FL 34711 | 2018-02-28 |
| 1306353842 | Center of Change Inc. | General Practice | 235 Citrus Tower Blvd Ste 104, Clermont, FL 34711 | 2018-01-05 |
| 1003328642 | Clermont Radiology LLC | Clinic/Center | 3725 South Highway 27, Suite 104, Clermont, FL 34711 | 2017-11-03 |
| Find all providers in zip 34711 | ||||
| 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 |
|---|---|---|---|---|
| 1346855426 | Alisa Lewis | Assisted Living Facility | 215 Pleasant Hill Dr, Clermont, FL 34711-2741 | 2020-09-15 |
| 1760043871 | Doralus Homecare Alf | Assisted Living Facility | 1441 13th St, Clermont, FL 34711-2878 | 2019-06-28 |
| 1801351770 | Supreme Senior Living, LLC | Assisted Living Facility | 502 Southridge Rd Fl 34711usa, Clermont, FL 34711-6487 | 2019-02-05 |
| 1508257023 | Crane's View Lodge LLC | Assisted Living Facility | 1601 Hook St, Clermont, FL 34711-3510 | 2015-02-06 |
| 1750784229 | Lakeshore Manor, LLC | Assisted Living Facility | 960 W Lakeshore Dr, Clermont, FL 34711-2932 | 2014-09-29 |
| 1639587108 | Indian Shore Manor, LLC | Assisted Living Facility | 1611 Indian Shore Dr, Clermont, FL 34711-2981 | 2014-07-29 |
| 1063752632 | Country Comfort Care, Inc. | Assisted Living Facility | 15340 Mallory Ln, Clermont, FL 34715-8708 | 2013-02-19 |
| 1629608013 | Clermont1818 Opco, LLC | Assisted Living Facility | 650 E Minnehaha Ave, Clermont, FL 34711-3445 | 2020-01-24 |
| 1982194494 | H-bay Ministries, Inc. | Assisted Living Facility | 1600 Hunt Trace Blvd, Clermont, FL 34711-5184 | 2018-05-10 |
| 1255752911 | Clermont Alf Investors, LLC | Assisted Living Facility | 1600 Hunt Trace Blvd, Clermont, FL 34711-5184 | 2013-12-26 |
| Find all providers in CLERMONT | ||||
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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.