FAMILY EXTENDED CARE OF WINTER HAVEN, INC. (NPI# 1730385246) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730385246 |
| Entity Type | Organization |
| Organization Name | FAMILY EXTENDED CARE OF WINTER HAVEN, INC. |
| Other Organization Name | THE HAWTHORNE INN |
| Practice Address |
625 Overlook Dr Winter Haven FL 33884-1626 |
| Practice Telephone | 8633242212 |
| Practice Fax Number | 8633188400 |
| Mailing Telephone | 8633242212 |
| Mailing Fax Number | 8633188400 |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. MARY PARRETT (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 9413420566 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL8947 | FL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| The Hawthorne Inn | Doing Business As Name - Organization |
| Street Address |
625 OVERLOOK DR |
| City | WINTER HAVEN |
| State | FL |
| Zip Code | 33884-1626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639202930 | Lesley Michelle O'bannon | Occupational Therapist | 625 Overlook Dr, Winter Haven, FL 33884-1626 | 2007-03-14 |
| 1144633918 | Lynn Harwell | Occupational Therapist | 625 Overlook Dr, Winter Haven, FL 33884-1626 | 2014-06-09 |
| 1548565005 | Mary Kristina Mathis | Speech-Language Pathologist | 625 Overlook Dr, Winter Haven, FL 33884-1626 | 2011-01-14 |
| 1528183647 | Wendy Jeanne Santiago | Physical Therapy Assistant | 625 Overlook Dr, Winter Haven, FL 33884-1626 | 2007-03-20 |
| 1215060520 | Kimberly Sue Kettinger | Physical Therapy Assistant | 625 Overlook Dr, Winter Haven, FL 33884-1626 | 2007-03-14 |
| 1295868511 | Ellen Danita Thomas | Occupational Therapy Assistant | 625 Overlook Dr, Winter Haven, FL 33884-1626 | 2007-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154956480 | Kristin Helen Kiddy | Occupational Therapy Assistant | 101 Overlook Drive, Suite 103, Winter Haven, FL 33884 | 2020-03-06 |
| 1871990143 | William Santo | Specialist/Technologist | 9269 Kliber Dr., Winter Haven, FL 33884 | 2014-12-02 |
| 1346656345 | Integrative Physical Medicine of Winter Haven LLC | Specialist | 7494 Cypress Gardens Blvd, Winter Haven, FL 33884 | 2014-07-10 |
| 1568808921 | Donald Lurton Arey Jr. | Surgery | 800 Island Way, Winter Haven, FL 33884 | 2013-05-13 |
| 1407195324 | Shena R. Ranon | Nurse Practitioner | 1820 Woodpointe Dr, Winter Haven, FL 33884 | 2013-02-13 |
| 1952654543 | Mpn Medical Center of Dundee | Family Medicine | 1023 Dundee Road, Winter Haven, FL 33884 | 2012-10-19 |
| 1588941736 | Cody Gernatt | Occupational Therapist | 1120 Cypress Gardens Blvd., Winter Haven, FL 33884 | 2011-11-15 |
| 1851611677 | Paulene T Jasurek | Pharmacist | 4454 Cypress Gardens Rd, Winter Haven, FL 33884 | 2010-06-03 |
| 1306169867 | John David Butters | Speech-Language Pathologist | 208 Escambia Dr., Winter Haven, FL 33884 | 2010-03-11 |
| 1710162813 | Humphrey Chiropractic Center, P.a. | Chiropractor | 605 Overlook Drive, Suite 1, Winter Haven, FL 33884 | 2008-01-08 |
| Find all providers in zip 33884 | ||||
| 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 |
|---|---|---|---|---|
| 1245761162 | Melissa Davis | Assisted Living Facility | 4364 Diamond Rd, Winter Haven, FL 33880-1502 | 2017-03-22 |
| 1336688258 | Ambitious Quality Care Assisted Living | Assisted Living Facility | 3939 Country Pl Apt C, Winter Haven, FL 33880-1519 | 2017-02-13 |
| 1023424405 | Autumn Breeze Assisted Living Facility Inc | Assisted Living Facility | 904 Lake Martha Dr Ne, Winter Haven, FL 33881-4278 | 2014-07-07 |
| 1992149397 | Nic 5 Spring Haven Leasing LLC | Assisted Living Facility | 1225 Nw Havendale Boulevard, Winter Haven, FL 33881 | 2013-04-29 |
| 1871863787 | Kapaali Holdings LLC | Assisted Living Facility | 2275 8th St Nw, Suite #114, Winter Haven, FL 33881-1331 | 2012-01-09 |
| 1730474420 | Successful Ambitions | Assisted Living Facility | 3939 Country Place Unit C, Winter Haven, FL 33880 | 2011-06-10 |
| 1972805364 | Brookdale Senior Living Communities, Inc. | Assisted Living Facility | 6110 Cypress Gardens Blvd, Winter Haven, FL 33884-4150 | 2010-11-17 |
| 1366603243 | Liberty Assisted Living | Assisted Living Facility | 5890 Cypress Gardens Blvd, Winter Haven, FL 33884-2274 | 2008-06-23 |
| 1891910337 | Omnia Cum Deo Corp | Assisted Living Facility | 2100 State Road 540 W, Winter Haven, FL 33880-1768 | 2007-04-17 |
| 1851998256 | Miss K's Enrichment Center Inc Dba Campbell's Landing Assisted Living | Assisted Living Facility | 904 Lake Martha Dr Ne, Winter Haven, FL 33881-4278 | 2020-10-08 |
| Find all providers in WINTER HAVEN | ||||
| City | WINTER HAVEN |
| Zip Code | 33884 |
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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.