ACTIVE SENIOR LIVING RESIDENCE, INC. (NPI# 1861557464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861557464 |
| Entity Type | Organization |
| Organization Name | ACTIVE SENIOR LIVING RESIDENCE, INC. |
| Practice Address |
9057 Nw 57th St Tamarac FL 33351-4305 |
| Practice Telephone | 9547211115 |
| Practice Fax Number | 9547214397 |
| Mailing Telephone | 9547211115 |
| Mailing Fax Number | 9547214397 |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. BETH ILONA TOKARZ (ADMINISTRATOR) |
| Authorized Official Telephone | 9547211115 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 9969 | FL | Nursing & Custodial Care Facilities |
| Street Address |
9057 NW 57TH ST |
| City | TAMARAC |
| State | FL |
| Zip Code | 33351-4305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215461157 | Active Serenity | Assisted Living Facility | 9057 Nw 57th St, Tamarac, FL 33351-4305 | 2017-04-18 |
| 1417371857 | Active Senior Living Residence | Assisted Living Facility | 9057 Nw 57th St, Tamarac, FL 33351-4305 | 2014-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811595945 | Nicole Walters | Nurse Practitioner | 4900 Nw 92nd Ave, Sunrise, FL 33351 | 2020-10-12 |
| 1811539141 | Springbirds Caregivers, Inc | Home Health | 8469 W Aokland Park Blvd, Sunrise, FL 33351 | 2019-10-08 |
| 1841842457 | Pacifica Sl Sunrise LLC | Assisted Living Facility | 4201 Springtree Drive, Sunrise, FL 33351 | 2019-07-13 |
| 1376019216 | Carla Sue Castiglione | Dietitian, Registered | 4800 Nob Hill Road, Sunrise, FL 33351 | 2018-10-18 |
| 1114493202 | Sunrise Family Smiles, Pa | Clinic/Center | 9440 West Commercial Blvd, Suite 105, Sunrise, FL 33351 | 2018-10-16 |
| 1134619505 | Brush Lauderhill, Pllc | Dentist | 7752 W. Commercial Blvd, Lauderhill, FL 33351 | 2018-05-11 |
| 1336658749 | Manuel Alexis Guilarte | Technician, Other | 10307 Nw 33rd Pl, Sunrise, FL 33351 | 2017-09-28 |
| 1801319009 | Latavia Cheri London | Technician, Other | 9429 Nw 42nd Street, 9429 Nw 42nd Street, Sunrise, FL 33351 | 2017-07-19 |
| 1225567662 | Maite Blanco | Counselor | 10994 Nw 40 Street, Sunrise, FL 33351 | 2017-06-08 |
| 1902335599 | Ella-shanie Benyakar | Speech-Language Pathologist | 9477 Nw 39th Pl, Sunrise, FL 33351 | 2017-06-07 |
| Find all providers in zip 33351 | ||||
| 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 |
|---|---|---|---|---|
| 1669946752 | Superior Care II Inc | Assisted Living Facility | 8025 Nw 83rd St, Tamarac, FL 33321-1745 | 2019-01-11 |
| 1235542572 | Loving Extended Family Home LLC | Assisted Living Facility | 5112 N Laurel Cir, Tamarac, FL 33319-3100 | 2014-06-04 |
| 1669893921 | Harborchase of Tamarac, Inc. | Assisted Living Facility | 6855 Nw 70th Ave, Tamarac, FL 33321-5326 | 2014-01-03 |
| 1750702783 | Lesly'leisure Living II | Assisted Living Facility | 6461 Nw 90th Ave, Tamarac, FL 33321-3621 | 2013-12-17 |
| 1033556733 | Gordon Heights, Inc | Assisted Living Facility | 9401 Nw 80th St, Tamarac, FL 33321-1408 | 2013-06-04 |
| 1881940542 | Lesly's Leisure Living Inc | Assisted Living Facility | 5841 Nw 56th Pl, Tamarac, FL 33319-2326 | 2012-07-31 |
| 1962794651 | New Horizon East Inc | Assisted Living Facility | 8112 Nw 74th Ter, Tamarac, FL 33321-4861 | 2011-05-12 |
| 1760797021 | Lakeview Retirement Residence, Inc. | Assisted Living Facility | 2304 Nw 52nd Ct, Tamarac, FL 33309-2681 | 2010-08-11 |
| 1295782530 | Heartland of Tamarac Fl LLC | Assisted Living Facility | 5901 Nw 79th Ave, Tamarac, FL 33321-4639 | 2006-05-30 |
| 1467089441 | The Pointe of Inverrary, LLC | Assisted Living Facility | 6700 W Commercial Blvd, Tamarac, FL 33319-2115 | 2020-03-27 |
| Find all providers in TAMARAC | ||||
Please comment or provide details below to improve the information on ACTIVE SENIOR LIVING RESIDENCE, INC..
| 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.