PHYLLIS BAIRD ADULT FAMILY CARE HOME (NPI# 1801138003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801138003 |
| Entity Type | Organization |
| Organization Name | PHYLLIS BAIRD ADULT FAMILY CARE HOME |
| Practice Address |
284 Comstock St Port Charlotte FL 33954-3627 |
| Practice Telephone | 9417430778 |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2013-03-26 |
| Authorized Official Name | PHYLLUS BAIRD (OWNER) |
| Authorized Official Telephone | 9417430778 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 3 | FL | Residential Treatment Facilities |
| Street Address |
284 COMSTOCK ST |
| City | PORT CHARLOTTE |
| State | FL |
| Zip Code | 33954-3627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043740665 | Criselda Veronica Romero | Home Health Aide | 24009 Madaca Lane, Apt 104, Port Charlotte, FL 33954 | 2017-06-15 |
| 1942469234 | Johanny Vizcarrondo Colon | Physical Therapist | 24011 Madaca Lane # 108, Port Charlotte, FL 33954 | 2008-06-03 |
| 1467638163 | Qrs LLC | Clinic/Center | 17218 Toledo Blade Blvd., Unit 7, Port Charlotte, FL 33954 | 2008-01-14 |
| 1023199155 | Visionworks Inc | Eyewear Supplier (Equipment, not the service) | 18500 Veterans Boulevard, Unit 4, Port Charlotte, FL 33954 | 2006-10-17 |
| 1174577290 | Karen Kalbfeld | Nurse Anesthetist, Certified Registered | 327 Kindred Blvd, Port Charlotte, FL 33954 | 2006-05-22 |
| 1518425081 | Annette Simmons | Custodial Care Facility | 1292 Dorchester St, Port Charlotte, FL 33954 | 2019-03-04 |
| 1942319744 | Lifeline Health Care of Southwest Florida, Inc. | Home Health | 630a Woodbury Dr, Port Charlotte, FL 33954-1000 | 2006-08-29 |
| 1154617553 | Anthony Richard La Forgia | Counselor | 630a Woodbury Dr, Port Charlotte, FL 33954-1000 | 2011-06-23 |
| 1780227199 | Sergio Pedro Castro | Behavioral Analyst | 18245 Paulson Dr Ste 113, Port Charlotte, FL 33954-1019 | 2019-10-18 |
| 1295201846 | Grissel Alfonso Gonzalez | Behavior Technician | 18245 Paulson Dr Ste 130, Port Charlotte, FL 33954-1019 | 2018-10-22 |
| Find all providers in zip 33954 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427688852 | Tropical Gardens LLC | Community Based Residential Treatment Facility, Mental Illness | 150 Ne 212th St, Miami Gardens, FL 33179-1017 | 2020-01-24 |
| 1417505850 | Herve Franck | Community Based Residential Treatment Facility, Mental Illness | 13901 Folkestone Cir, Wellington, FL 33414-7825 | 2019-08-28 |
| 1568014868 | Hestia House of Florida, Inc. | Community Based Residential Treatment Facility, Mental Illness | 816 N Grandview Ave # 2, Daytona Beach, FL 32118-3721 | 2019-07-16 |
| 1336628155 | Lavoryia Timmons | Community Based Residential Treatment Facility, Mental Illness | 24940 Hyde Park Blvd, Land O Lakes, FL 34639-6306 | 2018-08-13 |
| 1003324534 | Donyell Jones | Community Based Residential Treatment Facility, Mental Illness | 6239 Edgewater Dr Ste V2, Orlando, FL 32810-4764 | 2018-01-18 |
| 1437672748 | Reasons for Change, LLC | Community Based Residential Treatment Facility, Mental Illness | 143 Silver Beach Road, Lake Park, FL 33403 | 2017-07-18 |
| 1316477029 | Cerrato Associates Incorporation | Community Based Residential Treatment Facility, Mental Illness | 755 Shady Oaks Dr Apt 310, Palm Coast, FL 32164-2578 | 2017-06-14 |
| 1356877047 | Samaritan Counseling Center | Community Based Residential Treatment Facility, Mental Illness | 101 Se 3rd Avenue, Fort Lauderdale, FL 33301 | 2017-05-02 |
| 1780119917 | Open Arm Housing and Care | Community Based Residential Treatment Facility, Mental Illness | 4031 Nw 91st Ters, Sunrise, FL 33351 | 2017-04-25 |
| 1124476064 | Parent Support, LLC | Community Based Residential Treatment Facility, Mental Illness | 146 Sunset View Dr., Davenport, FL 33896 | 2016-06-01 |
| Find all providers with the same taxonomy | ||||
| City | PORT CHARLOTTE |
| Zip Code | 33954 |
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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.