SRI AT HEALTH PARK, LLC (NPI# 1063833788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063833788 |
| Entity Type | Organization |
| Organization Name | SRI AT HEALTH PARK, LLC |
| Other Organization Name | SUPERIOR RESIDENCES AT HEALTH PARK |
| Practice Address |
9461 Healthpark Cir Fort Myers FL 33908-3614 |
| Practice Telephone | 2394375511 |
| Mailing Telephone | 2394375511 |
| Enumeration Date | 2013-12-23 |
| Last Update Date | 2013-12-23 |
| Authorized Official Name | DENNIS MCCARTHY (CIO) |
| Authorized Official Telephone | 3526863831 |
| Is Organization Subpart | Y |
| Parent Organization Name | SUPERIOR RESIDENCES, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 9346 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | AHCA | 9346 | 01 |
| Other Name | Type Code |
|---|---|
| Superior Residences at Health Park | Doing Business As Name - Organization |
| Street Address |
9461 HEALTHPARK CIR |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33908-3614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679984389 | Extended Care Portfolio Florida Tenant LLC | Assisted Living Facility | 9461 Healthpark Cir, Fort Myers, FL 33908-3614 | 2014-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760081806 | 1 Recovery | Community/Behavioral Health | 111 Daniels Dr, Fort Myers, FL 33908 | 2020-10-20 |
| 1457916462 | Avipharm, LLC | Pharmacy | 7669 Calistoble Loop, 2nd Floor, Fort Myers, FL 33908 | 2019-05-06 |
| 1013492289 | Craig M Stein | Pharmacist | 15236 Tropic Bird Court, Fort Myers, FL 33908 | 2018-10-03 |
| 1730665167 | Kyndra Lynn Petrick | Psychiatry & Neurology | 8560 Big Mangrove Dr, Fort Myers, FL 33908 | 2018-07-18 |
| 1447757547 | Douglas L Jarrett | Nurse Practitioner | 16261 Bass Rd Suite 300, Fort Myers, FL 33908 | 2018-04-06 |
| 1447754825 | Luis Daniel Ramos | General Practice | 15590 Ocean Walk Cir Apt 201, Fort Myers, FL 33908 | 2018-03-21 |
| 1619497062 | Vanesa Paola Vaquer | Dentist | 18070 S Tamiami Trl Ste 101, Fort Myers, FL 33908 | 2017-06-26 |
| 1962859603 | Teresa Ruiz | Behavior Technician | 15081 Woodrich Bend Ct Apt 416, Fort Myers, FL 33908 | 2016-05-23 |
| 1669865721 | Elena B. Alexiev | Dentist | 18070 S. Tamiami Trail, #101, Fort Myers, FL 33908 | 2015-03-13 |
| 1134488919 | Cecelia Anne Collins | Dietitian, Registered | 9215 Calle Arragon Avenue, Unit 205, Fort Myers, FL 33908 | 2012-05-14 |
| Find all providers in zip 33908 | ||||
| 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 |
|---|---|---|---|---|
| 1346703774 | Jahphet Y Grant | Assisted Living Facility | 2252 Wright St # A, Fort Myers, FL 33916-4345 | 2019-04-11 |
| 1255874806 | Southen Oaks Senior Living Care LLC | Assisted Living Facility | 2117 Earl Rd, Fort Myers, FL 33901-8015 | 2016-11-30 |
| 1609237163 | Avalon Manor Assisted Living Facility LLC | Assisted Living Facility | 2580 First St, Fort Myers, FL 33901-2410 | 2016-03-11 |
| 1700253531 | Coral House Assisted Living Community, LLC | Assisted Living Facility | 3501 Hancock Bridge Pkwy, Fort Myers, FL 33903-7095 | 2015-08-27 |
| 1386073088 | The Christian & Missionary Alliance Foundation Inc | Assisted Living Facility | 3600 Kings Crown Ct, Fort Myers, FL 33908-1648 | 2013-11-04 |
| 1093140451 | The Christian & Missionary Alliance Foundation Inc | Assisted Living Facility | 13901 Shell Point Plz, Fort Myers, FL 33908-2898 | 2013-09-04 |
| 1548507866 | Festa Enterprises Inc. | Assisted Living Facility | 6722 Winkler Rd, Fort Myers, FL 33919-7204 | 2013-01-07 |
| 1679875041 | Brookdale Senior Living Communities, Inc. | Assisted Living Facility | 14521 Lakewood Blvd, Fort Myers, FL 33919-2829 | 2010-11-17 |
| 1073743167 | Ho Operating Company, LLC | Assisted Living Facility | 3625 Hidden Tree Ln, Fort Myers, FL 33901-8388 | 2009-07-23 |
| 1215184023 | Arden Courts of Ft Myers Fl LLC | Assisted Living Facility | 15950 Mcgregor Blvd, Fort Myers, FL 33908-2551 | 2008-08-22 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33908 |
Please comment or provide details below to improve the information on SRI AT HEALTH PARK, LLC.
| 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.