EXTENDED CARE PORTFOLIO TENANT, LLC (NPI# 1912330424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912330424 |
| Entity Type | Organization |
| Organization Name | EXTENDED CARE PORTFOLIO TENANT, LLC |
| Other Organization Name | PACIFICA SENIOR LIVING WOODMONT |
| Practice Address |
3207 N Monroe St Tallahassee FL 32303-2832 |
| Mailing Address |
13770 58th St N Suite 312 Clearwater FL 33760-3759 |
| Practice Telephone | 8505624123 |
| Mailing Telephone | 7277263980 |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2013-08-20 |
| Authorized Official Name | TERESA EDWARDS (MANAGER) |
| Authorized Official Telephone | 7277263980 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL99 | FL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Pacifica Senior Living Woodmont | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932532942 | Extended Care Portfolio Tenant, LLC | Alzheimer Center (Dementia Center) | 9015 University Pkwy, Pensacola, FL 32514-5525 | 2013-08-13 |
| Street Address |
3207 N MONROE ST |
| City | TALLAHASSEE |
| State | FL |
| Zip Code | 32303-2832 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679051601 | Anna Jacobs | Occupational Therapy Assistant | 6040 Michaela Way, Tallahassee, FL 32303 | 2018-08-01 |
| 1780101501 | Jacqueline Lee Barksdale | Social Worker | 975 Commonwealth Blvd, Tallahasse, FL 32303 | 2017-08-23 |
| 1780118547 | Osborne LLC | Social Worker | 1018 Thomasville Road, Tallahassee, FL 32303 | 2017-04-18 |
| 1528508215 | Klc Personal Care | Assisted Living Facility | 5743 Jodphur Ct, Tallahassee, FL 32303 | 2017-03-01 |
| 1285180109 | Jenetta R Nelson | Social Worker | 807 Goodbread Lane, Tallahassee, FL 32303 | 2016-08-31 |
| 1902359805 | Brandon Alkire | Physical Therapist | 1660 N. Monroe St, #3, Tallahassee, FL 32303 | 2016-07-27 |
| 1093050957 | Kenneth A. Folsom | Hearing Instrument Specialist | 903 N Monroe St, #3, Tallahassee, FL 32303 | 2012-12-04 |
| 1235481466 | Annika Elizabeth Suarez | Speech-Language Pathologist | 1808 Medart Dr, Tallahassee, FL 32303 | 2012-10-11 |
| 1912257510 | David Voorting | Social Worker | 3107 Evanshire Place, Tallahassee, FL 32303 | 2012-09-12 |
| 1760754816 | Catherine Cleveland Smith | Physical Therapy Assistant | 5020 Riverwood Rd, Tallahassee, FL 32303 | 2012-02-06 |
| Find all providers in zip 32303 | ||||
| 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 |
|---|---|---|---|---|
| 1356962864 | Our Peacehouse LLC | Assisted Living Facility | 1502 W Tharpe St, Tallahassee, FL 32303-4544 | 2020-05-06 |
| 1598243016 | Tapestry Tallahassee Walden, LLC | Assisted Living Facility | 3080 Walden Rd, Tallahassee, FL 32317-7905 | 2018-08-06 |
| 1780176818 | Brittany Johnson | Assisted Living Facility | 4527 Deslin Dr, Tallahassee, FL 32305-7493 | 2018-06-04 |
| 1487199840 | Tallahassee Nhhi, LLC | Assisted Living Facility | 2516 Lakeshore Dr, Tallahassee, FL 32312-2104 | 2016-12-21 |
| 1215374731 | Linda Williams | Assisted Living Facility | 2069 Dellwood Dr, Tallahassee, FL 32303-4817 | 2013-05-23 |
| 1902108418 | Eldercare Services of Tallahassee | Assisted Living Facility | 2507 Old Saint Augustine Rd, Tallahassee, FL 32301-6209 | 2010-12-03 |
| 1538313416 | La Grand Belle Estates | Assisted Living Facility | 5898 Orchard Pond Rd, Tallahassee, FL 32303-8200 | 2008-11-05 |
| 1538367388 | Catherine's House, Inc. | Assisted Living Facility | 6595 Damon Cir, Tallahassee, FL 32304-8706 | 2007-07-03 |
| 1548681802 | Harborchase of Tallahassee, Inc. | Assisted Living Facility | 100 John Knox Rd, Tallahassee, FL 32303-6673 | 2014-01-03 |
| 1669729406 | Columbia Crest Construction, LLC | Assisted Living Facility | 3909 Reserve Dr, Ste 2818, Tallahassee, FL 32311-8200 | 2012-08-11 |
| Find all providers in TALLAHASSEE | ||||
| City | TALLAHASSEE |
| Zip Code | 32303 |
Please comment or provide details below to improve the information on EXTENDED CARE PORTFOLIO TENANT, LLC.
| 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.