SOMH BOCA RATON OPERATING, LLC (NPI# 1114527744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114527744 |
| Entity Type | Organization |
| Organization Name | SOMH BOCA RATON OPERATING, LLC |
| Practice Address |
21865 Ponderosa Dr Boca Raton FL 33428-6215 |
| Practice Telephone | 5615717018 |
| Practice Fax Number | 5614825033 |
| Mailing Telephone | 5615717018 |
| Mailing Fax Number | 5614825033 |
| Enumeration Date | 2020-11-01 |
| Last Update Date | 2020-11-01 |
| Authorized Official Name | MR. HENRY JAMES VAUGHN (REIMBURSEMENT ANALYST) |
| Authorized Official Telephone | 2405956025 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 311500000X | Alzheimer Center (Dementia Center) | Nursing & Custodial Care Facilities | ||
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| The Meridian at Boca Raton | Doing Business As Name - Organization |
| Street Address |
21865 PONDEROSA DR |
| City | BOCA RATON |
| State | FL |
| Zip Code | 33428-6215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174016604 | Eliane Dos Santos Lamarche | Behavior Technician | 11514 Country Sound Ct, Boca Raton, FL 33428 | 2018-06-09 |
| 1447740840 | Wilzade Joseph | Assisted Living Facility | 22319 Sw 65th Ave, Boca Raton, FL 33428 | 2018-05-11 |
| 1477065316 | Pamela Manning | Nurse Practitioner | 9864 Grand Verde Way Apt 1507, Boca Raton, FL 33428 | 2017-11-01 |
| 1912428624 | Carole Mandat | Assistant Behavior Analyst | 11083 Baybreeze Way, Boca Raton, FL 33428 | 2017-07-03 |
| 1679025571 | Tam Thu Tran | Physician Assistant | 22864 Neptune Road, Boca Raton, FL 33428 | 2016-10-27 |
| 1922458355 | Zurab Akakievich Iosava | Specialist/Technologist, Other | 21644 State Road 7. (hwy 441), Boca Raton, FL 33428 | 2016-06-16 |
| 1497125280 | Robert Jay Drimmer | Internal Medicine | 21357 Bridgeview Drive, Boca Raton, FL 33428 | 2015-10-06 |
| 1710391966 | Pathway 2 Recovery Gold Coast | Clinic/Center | 23116a Sandal Foot Plaza Drive, Boca Raton, FL 33428 | 2014-06-16 |
| 1134564727 | Mary Margaret Spitzer | Nurse Practitioner | 9980 Central Park Blvdn, Boca Ration, FL 33428 | 2013-05-08 |
| 1619312816 | Alan Wasserman | Dentist | 22053 S.r. 7, Boca Raton, FL 33428 | 2013-05-02 |
| Find all providers in zip 33428 | ||||
| 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 |
|---|---|---|---|---|
| 1174185102 | Blue Ribbon Care Assisted Living Facility II, LLC | Assisted Living Facility | 22594 Sw 65th Ter, Boca Raton, FL 33428-6049 | 2019-06-29 |
| 1154805802 | Palliser Assisted Living LLC | Assisted Living Facility | 9536 Old Pine Rd, Boca Raton, FL 33428-3056 | 2018-09-19 |
| 1447740840 | Wilzade Joseph | Assisted Living Facility | 22319 Sw 65th Ave, Boca Raton, FL 33428 | 2018-05-11 |
| 1154865756 | Golden Swan of Boca | Assisted Living Facility | 19494 Hampton Dr, Boca Raton, FL 33434-2844 | 2016-12-15 |
| 1841645082 | Havencrest Alf LLC | Assisted Living Facility | 2880 Nw 25th Way, Boca Raton, FL 33434-3698 | 2016-04-25 |
| 1598147530 | Federation Ccrc Operations Corp. | Assisted Living Facility | 21044 95th Ave S, Boca Raton, FL 33428-1500 | 2015-06-26 |
| 1114318052 | Rockwell Seniors | Assisted Living Facility | 22198 Ensenada Way, Boca Raton, FL 33433-4613 | 2015-02-13 |
| 1295123172 | Banyan Realty Br, LLC | Assisted Living Facility | 2950 Nw 5th Ave, Boca Raton, FL 33431-8226 | 2014-12-31 |
| 1548694482 | The Trusttees of Advent Lutheran Church, Inc. / Advent Square | Assisted Living Facility | 4798 N Dixie Hwy, Boca Raton, FL 33431-5055 | 2013-08-28 |
| 1578903019 | The Atrium of Boca Raton | Assisted Living Facility | 1080 Nw 15th St, Boca Raton, FL 33486-1331 | 2013-06-28 |
| Find all providers in BOCA RATON | ||||
| City | BOCA RATON |
| Zip Code | 33428 |
Please comment or provide details below to improve the information on SOMH BOCA RATON OPERATING, 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.