ASBURY PENSACOLA PLC LLC (NPI# 1922512532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922512532 |
| Entity Type | Organization |
| Organization Name | ASBURY PENSACOLA PLC LLC |
| Other Organization Name | ASBURY PLACE |
| Practice Address |
4916 Mobile Hwy Pensacola FL 32506-3230 |
| Mailing Address |
3630 Illinois Rd Fort Wayne IN 46804-2062 |
| Practice Telephone | 8504530100 |
| Mailing Telephone | 2607979482 |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2017-11-20 |
| Authorized Official Name | MR. ROBERT EDWARD PETRAS JR. (CO-OWNER/COO) |
| Authorized Official Telephone | 2607979482 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Asbury Place | Doing Business As Name - Organization |
| Street Address |
4916 MOBILE HWY |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32506-3230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295082246 | Cooper-solice Inc Dba Asbury Place | Assisted Living Facility | 4916 Mobile Hwy, Pensacola, FL 32506-3230 | 2012-08-09 |
| 1255976981 | Nss-alf Pensacola LLC | Assisted Living Facility | 4916 Mobile Hwy, Pensacola, FL 32506-3230 | 2019-11-18 |
| 1699145714 | Asbury Place Alf Bslc LLC | Assisted Living Facility | 4916 Mobile Hwy, Pensacola, FL 32506-3230 | 2015-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093332942 | Abigail Irene Dudek | Behavior Technician | 6800 West Us-98, Pensacola, FL 32506 | 2020-06-26 |
| 1053957274 | Melissa Marie Swango | Technician | 3 Usher Cir, Pensacola, FL 32506 | 2019-11-22 |
| 1215479506 | Kerry Jo Pham | Advanced Practice Midwife | 225 N New Warrington Rd, Pensacola, FL 32506 | 2016-11-17 |
| 1750761375 | Congleton Eye Care, LLC | Optometrist | 4600 Mobile Hwy, Suite 122, Pensacola, FL 32506 | 2015-06-09 |
| 1033312293 | Rogelio Tridanio Martinez Sr. | Pain Medicine | 4806 Mobile Highway, Suite D, Pensacola, FL 32506 | 2007-06-06 |
| 1215023726 | Martha Goff | Pharmacist | 50 S. Blue Angel Parkway, Pensacola, FL 32506 | 2006-10-04 |
| 1881703635 | John Daniel Hodge | Dentist | 4800 W Fairfield Dr, Pensacola, FL 32506 | 2006-08-29 |
| 1417066275 | Fairfield Dental Center | Dentist | 4800 W. Fairfield Drive, Pensacola, FL 32506 | 2006-08-29 |
| 1942277793 | Phillip Martine Drlicka | Dentist | 901 N Warrington Rd, Pensocola, FL 32506 | 2006-03-01 |
| 1083694186 | Lester Shawn Bowling | Internal Medicine | 321 South Fairfield Dr, Pensacola, FL 32506 | 2006-01-17 |
| Find all providers in zip 32506 | ||||
| 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 |
|---|---|---|---|---|
| 1821617333 | Shelton Manor Inc | Assisted Living Facility | 9700 Pensacola Blvd, Pensacola, FL 32534-1242 | 2020-04-14 |
| 1831660240 | The Rhema House | Assisted Living Facility | 2910 Michael Dr, Pensacola, FL 32505-3999 | 2018-12-10 |
| 1033619093 | Prisyco Manor LLC | Assisted Living Facility | 8061 Groveland Ave, Pensacola, FL 32534-3551 | 2018-02-16 |
| 1578989695 | Grandview Retirement Center | Assisted Living Facility | 1706 E Olive Rd, Pensacola, FL 32514-7553 | 2014-03-13 |
| 1679998389 | House of Honor, LLC | Assisted Living Facility | 8090 Tippin Ave, Pensacola, FL 32514-6357 | 2014-03-04 |
| 1235551672 | Ashley Leggett | Assisted Living Facility | 1030 Jojo Rd, Pensacola, FL 32514-3235 | 2014-01-18 |
| 1255763256 | Extended Care Portfolio Florida Tenant, LLC | Assisted Living Facility | 5918 N Davis Hwy, Pensacola, FL 32503-2050 | 2013-08-01 |
| 1295082246 | Cooper-solice Inc Dba Asbury Place | Assisted Living Facility | 4916 Mobile Hwy, Pensacola, FL 32506-3230 | 2012-08-09 |
| 1619271525 | Northpointe Retirement Community | Assisted Living Facility | 5100 Northpointe Pkwy, Pensacola, FL 32514-7844 | 2011-01-06 |
| 1972807881 | Westpointe Retirement Community | Assisted Living Facility | 5101 Northpointe Pkwy, Pensacola, FL 32514-7846 | 2011-01-06 |
| Find all providers in PENSACOLA | ||||
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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.