EXTENDED CARE PORTFOLIO TENANT, LLC (NPI# 1932532942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932532942 |
| Entity Type | Organization |
| Organization Name | EXTENDED CARE PORTFOLIO TENANT, LLC |
| Other Organization Name | PACIFICA SENIOR LIVING CREEKSIDE |
| Practice Address |
9015 University Pkwy Pensacola FL 32514-5525 |
| Mailing Address |
13770 58th St N Suite 312 Clearwater FL 33760-3759 |
| Practice Telephone | 8504776400 |
| Mailing Telephone | 7277263980 |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2013-08-13 |
| Authorized Official Name | MINDY MYERS (MANAGER) |
| Authorized Official Telephone | 7277263980 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311500000X | Alzheimer Center (Dementia Center) | AL9068 | FL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Pacifica Senior Living Creekside | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912330424 | Extended Care Portfolio Tenant, LLC | Assisted Living Facility | 3207 N Monroe St, Tallahassee, FL 32303-2832 | 2013-08-20 |
| Street Address |
9015 UNIVERSITY PKWY |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32514-5525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588986640 | Tlc Rehab Inc | Physical Therapist | 9015 University Pkwy, Pensacola, FL 32514-5525 | 2010-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568920643 | Cameron Rae Mackey | Student in an Organized Health Care Education/Training Program | 9091 Aiway Dr, Apt 622, Pensacola, FL 32514 | 2019-03-07 |
| 1083182612 | B & B of Pensacola LLC | Home Health | 2024 E Olive Rd, Pensacola, FL 32514 | 2018-11-13 |
| 1902398423 | Chana Levy | Developmental Therapist | 10080 Hillview Dr # 387b, Pensacola, FL 32514 | 2018-05-31 |
| 1629407663 | James Daniel Langston | Registered Nurse | 8383 North Davie Highway, Pensacola, FL 32514 | 2013-11-08 |
| 1174956197 | Valerie Kuloba | Pharmacist | 9251 University Parkway, Pensacola, FL 32514 | 2013-08-13 |
| 1548550924 | Pamela Lynn Trammel | Nurse Practitioner | 8383 North Davis Hywy, West Florida Hospital, Pensacola, FL 32514 | 2011-04-19 |
| 1659609378 | Michael Smith | Physical Therapy Assistant | 10100 Hillveiw Dr., Pensacola, FL 32514 | 2009-11-19 |
| 1154582906 | Karen Buchanan Bailey | Dentist | 2322 Copter Road, Pensacola, FL 32514 | 2008-06-24 |
| 1811181985 | Sandra Paquingan Kloman | Registered Nurse | 9400 University Parkway #10c, Medical Professional Agency, Pensacola, FL 32514 | 2007-08-31 |
| 1083826523 | Renfroe Spinal Center LLC | Chiropractor | 1421 East Nine Mile Rd, Pensacola, FL 32514 | 2007-05-04 |
| Find all providers in zip 32514 | ||||
| Taxonomy Code | 311500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Alzheimer Center (Dementia Center) |
| A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer’s Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114527744 | Somh Boca Raton Operating, LLC | Alzheimer Center (Dementia Center) | 21865 Ponderosa Dr, Boca Raton, FL 33428-6215 | 2020-11-01 |
| 1417556978 | Mh Gentry Park Al Operating, LLC | Alzheimer Center (Dementia Center) | 3201 Center Pointe Dr, Orlando, FL 32825-6323 | 2020-10-25 |
| 1144876327 | Immaculate Adult Day Care LLC | Alzheimer Center (Dementia Center) | 234 Willard St Ste A, Cocoa, FL 32922-7984 | 2019-08-14 |
| 1982172995 | Pacifica Augustine Road LLC | Alzheimer Center (Dementia Center) | 10660 Old Augustine Road, Jacksonville, FL 32257 | 2018-11-07 |
| 1689152910 | American Eagle Leesburg Mc LLC | Alzheimer Center (Dementia Center) | 710 S Lake St, Leesburg, FL 34748-7327 | 2018-07-30 |
| 1518445857 | American Eagle Venice Island LLC | Alzheimer Center (Dementia Center) | 1200 Avenida Del Circo, Venice, FL 34285 | 2018-07-30 |
| 1780160192 | Ganesh Healthcare of Jax LLC | Alzheimer Center (Dementia Center) | 644 Cesery Blvd Ste 150, Jacksonville, FL 32211 | 2018-07-18 |
| 1861917171 | Memory Lane Cottage At Oviedo, LLC | Alzheimer Center (Dementia Center) | 450 Oviedo Blvd, Oviedo, FL 32765-3508 | 2017-08-08 |
| 1891219119 | Waveney Gittens-williams | Alzheimer Center (Dementia Center) | 3706 W. Idle Wild Cir #203, Tampa, FL 33614 | 2017-07-28 |
| 1831640697 | Senior Living Iv Sun City, LLC | Alzheimer Center (Dementia Center) | 1320 33rd St Se, Ruskin, FL 33573-4904 | 2016-10-17 |
| Find all providers with the same taxonomy | ||||
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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.