COLLEEN ADULT FAMILY CARE HOME (NPI# 1538608930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538608930 |
| Entity Type | Organization |
| Organization Name | COLLEEN ADULT FAMILY CARE HOME |
| Practice Address |
5615 Royal Hills St Winter Haven FL 33881-7703 |
| Practice Telephone | 8633071298 |
| Mailing Telephone | 8633071298 |
| Enumeration Date | 2017-02-17 |
| Last Update Date | 2019-03-06 |
| Authorized Official Name | COLLEEN MARSHALL (OWNER) |
| Authorized Official Telephone | 8633071298 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251E00000X | Home Health | 6906156 | FL | Agencies |
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 143074200 | 05 |
| Street Address |
5615 ROYAL HILLS ST |
| City | WINTER HAVEN |
| State | FL |
| Zip Code | 33881-7703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114534476 | Ctc's Heart of Caring, Inc | In Home Supportive Care | 2995 Eagle Nest View Drive, Winter Haven, FL 33881 | 2020-09-29 |
| 1356813869 | Michael Thomas Wiernicki | Dentist | 1074 Spring Lake Plaza, Winter Haven, FL 33881 | 2018-12-21 |
| 1659862423 | Patricia Pelt | Social Worker | 3073 Buckeye Point Dr, Winter Haven, FL 33881 | 2018-05-28 |
| 1952891244 | Ansley Health LLC | Home Health | 1502 6th Ct Ne, Winter Haven, FL 33881 | 2018-05-14 |
| 1346699261 | Yovanka Zapata | Specialist/Technologist, Other | 5856 Windrigde Dr., Winter Haven, FL 33881 | 2016-06-10 |
| 1720415599 | Villa Pharmacy LLC | Pharmacy | 105 Avenue R Nw, Winter Haven, FL 33881 | 2013-10-10 |
| 1992149397 | Nic 5 Spring Haven Leasing LLC | Assisted Living Facility | 1225 Nw Havendale Boulevard, Winter Haven, FL 33881 | 2013-04-29 |
| 1780938225 | Penelope Sturdevant | Nurse Practitioner | 2791 Lake Alfred Rd., Winter Haven, FL 33881 | 2012-11-06 |
| 1649548165 | Tim R Acree | Non-emergency Medical Transport (VAN) | 2 Eagles Nest, Winter Haven, FL 33881 | 2011-12-12 |
| 1285899419 | Adjustment and Awareness Counseling | Community/Behavioral Health | 243 3rd St Nw, Winter Haven, FL 33881 | 2008-07-28 |
| Find all providers in zip 33881 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730621590 | None At This Time | Custodial Care Facility | 725 Crestwood Dr, Winter Haven, FL 33881-2919 | 2016-11-10 |
| 1831552785 | Linda Edler | Custodial Care Facility | 132 Madera Dr, Winter Haven, FL 33880-5678 | 2016-03-29 |
| 1326410515 | Franteria N Hall | Custodial Care Facility | 5871 Windridge Dr, Winter Haven, FL 33881-8793 | 2015-10-27 |
| 1053704981 | Kimberly Inez Adams | Custodial Care Facility | 4681 Mandolin Loop, Winter Haven, FL 33884-3599 | 2015-03-17 |
| 1316288475 | Guardian Adult Home Care | Custodial Care Facility | 439 Avenue D Se, Winter Haven, FL 33880-3531 | 2013-03-13 |
| 1740684554 | Gena Obry | Custodial Care Facility | 439 Avenue D Se, Winter Haven, FL 33880-3531 | 2014-10-22 |
| 1023410545 | Gena Obry | Custodial Care Facility | 439 Avenue D Se, Winter Haven, FL 33880-3531 | 2014-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497243 | Two Kinds of Hearts 'llc' | Custodial Care Facility | 1808 Oak Pond Street, Ruskin, FL 33570 | 2020-11-03 |
| 1881293843 | Inspire Family Home Care LLC. | Custodial Care Facility | 566 Forsyth Creek Ct, Apopka, FL 32712-3318 | 2020-10-21 |
| 1336747658 | Eddrena Thornton | Custodial Care Facility | 2233 Bluebird Ave, Bartow, FL 33830-2953 | 2020-10-09 |
| 1689280083 | Wendy Del Rosario Toledo Machado | Custodial Care Facility | 7101 Green St, New Port Richey, FL 34652-1630 | 2020-09-21 |
| 1568077469 | Titilayo M Dipe | Custodial Care Facility | 11215 Gold Compass St, Gibsonton, FL 33534-5698 | 2020-09-09 |
| 1124630892 | Moselene Belizaire | Custodial Care Facility | 3411 9th St W, Lehigh Acres, FL 33971-5357 | 2020-08-23 |
| 1396354395 | Unique Adult Family Care Home Inc. | Custodial Care Facility | 7149 Glenwood Dr, Boynton Beach, FL 33436-9404 | 2020-07-24 |
| 1790301687 | Nancy Isidor | Custodial Care Facility | 1728 Burnham Ct, Clermont, FL 34714-8048 | 2020-06-17 |
| 1326662206 | Yuwaret Haines | Custodial Care Facility | 13566 Rudi Loop, Spring Hill, FL 34609-7964 | 2020-06-05 |
| 1245854686 | Yves Carmen Dorsainvil | Custodial Care Facility | 631 Sw Sardinia Ave, Port Saint Lucie, FL 34953-3746 | 2020-06-01 |
| Find all providers with the same taxonomy | ||||
| City | WINTER HAVEN |
| Zip Code | 33881 |
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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.