PORTLAND ASSISTED LIVING FACILITY (NPI# 1326433681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326433681 |
| Entity Type | Organization |
| Organization Name | PORTLAND ASSISTED LIVING FACILITY |
| Other Organization Name | PORTLAND ALF |
| Practice Address |
4664 Nw 58th Ter Coral Springs FL 33067-2115 |
| Mailing Address |
8758 Cobblestone Point Cir Boynton Beach FL 33472-4458 |
| Practice Telephone | 9546036954 |
| Mailing Telephone | 5618708546 |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2015-04-03 |
| Authorized Official Name | MR. RANDY S MOODIE (ADMINISTRATOR) |
| Authorized Official Telephone | 5618708546 |
| Authorized Official Credential | PHARM.D |
| Is Organization Subpart | Y |
| Parent Organization Name | PORTLAND HEALTHCARE INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL12536 | FL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Portland ALF | Doing Business As Name - Organization |
| Street Address |
4664 NW 58TH TER |
| City | CORAL SPRINGS |
| State | FL |
| Zip Code | 33067-2115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306487822 | Amy Caplan Demner | Counselor | 5571 University Drive, Suite 101, Coral Springs, FL 33067 | 2019-10-06 |
| 1548825508 | Stacie Boyar | Counselor | 5941 N University Drive, Coral Springs, FL 33067 | 2019-05-06 |
| 1356818587 | National Vision Inc | Technician/Technologist | 6357 West Sample Road, Coral Springs, FL 33067 | 2018-10-25 |
| 1316423544 | R & S Dme Services, LLC | Durable Medical Equipment & Medical Supplies | 7551 Wiles Road, 103, Coral Springs, FL 33067 | 2018-07-11 |
| 1740787068 | Cleveland Clinic Florida (a Nonprofit Corporation) | Clinic/Center | 5701 North University Drive, Coral Springs, FL 33067 | 2018-04-12 |
| 1922500966 | South Florida Spinal Neurosurgery Associates LLC | Neurological Surgery | 5280 West Sample Road, Suite 203, Coral Springs, FL 33067 | 2018-03-06 |
| 1518481829 | Alissa Diaz | Pharmacist | 8360 Nw 51st Ct, Coral Springs, FL 33067 | 2017-07-28 |
| 1396267100 | Coral Springs Modern Dentistry, Pa | Dentist | 5810 Wiles Rd, Coral Springs, FL 33067 | 2017-07-13 |
| 1528595766 | Farahnaz Abdoly | Optometrist | 6357 W Sample Rd, Coral Springs, FL 33067 | 2017-05-18 |
| 1164894903 | Mar Christian Amoroso Panambo | Physical Therapist | 5900 West Sample Rd, 304, Coral Springs, FL 33067 | 2015-10-20 |
| Find all providers in zip 33067 | ||||
| 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 |
|---|---|---|---|---|
| 1598389652 | Fellowship Haven, LLC | Assisted Living Facility | 10968 Nw 9th Mnr, Coral Springs, FL 33071-6480 | 2020-06-04 |
| 1992351522 | Hart Assisted Living, LLC | Assisted Living Facility | 3641 Nw 79th Ave, Coral Springs, FL 33065-3032 | 2019-08-09 |
| 1447605456 | Comfort Springs Home Care Inc | Assisted Living Facility | 1326 Nw 113th Ter, Coral Springs, FL 33071-6471 | 2016-04-27 |
| 1669893905 | Harborchase of Coral Springs, Inc. | Assisted Living Facility | 2975 Nw 99th Way, Coral Springs, FL 33065-5084 | 2014-01-03 |
| 1205262276 | Paradise Villa Retirement Homes Inc | Assisted Living Facility | 4275 Nw 67th Way, Coral Springs, FL 33067-3025 | 2013-09-22 |
| 1235563263 | Keval Exquisite Care LLC | Assisted Living Facility | 2631 Nw 107th Ave, Coral Springs, FL 33065-3618 | 2013-08-27 |
| 1053743708 | Superior Care Inc. | Assisted Living Facility | 11412 Nw 1st Pl, Coral Springs, FL 33071-8107 | 2013-08-05 |
| 1205278009 | Harmony Place Alf | Assisted Living Facility | 11937 Nw 31st St, Coral Springs, FL 33065-3329 | 2013-07-22 |
| 1780026526 | Gardens At Maplewood | Assisted Living Facility | 1342 Nw 104th Dr, Coral Springs, FL 33071-3900 | 2013-07-22 |
| 1477995207 | Gardens At Coral Springs | Assisted Living Facility | 2971 Nw 95th Ave, Coral Springs, FL 33065-5097 | 2013-07-22 |
| Find all providers in CORAL SPRINGS | ||||
| City | CORAL SPRINGS |
| Zip Code | 33067 |
Please comment or provide details below to improve the information on PORTLAND ASSISTED LIVING FACILITY.
| 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.