NPI |
1306495692 |
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number. |
Entity Type Code |
2 |
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
Employer Identification Number EIN |
|
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified. |
Provider Organization Name Legal Business Name |
IMPERIAL GARDENS RESIDENTIAL CARE LLC |
The name of the organization provider. If the provider is an organization, this is the legal business name. |
Provider First Line Business Practice Location Address |
13300 NW 18TH CT |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
Provider Business Practice Location Address City Name |
MIAMI |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address State Name |
FL |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address Postal Code |
331671527 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number. |
Provider Business Practice Location Address Telephone Number |
7543671698 |
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
Provider Enumeration Date |
9/9/2019 |
The last name of the provider. If the provider is an individual, this is the legal name. |
Last Update Date |
11/8/2019 |
The first name of the provider, if the provider
is an individual. |
Authorized Official Last Name |
ALLEN |
The middle name of the provider, if the provider
is an individual. |
Authorized Official First Name |
LATESHIA |
The name prefix or salutation of the provider
if the provider is an individual; for example, Mr., Mrs., or Corporal. |
Authorized Official Title or Position |
OWNER |
The abbreviations for professional degrees or credentials used or held by the provider,
if the provider is an individual. Examples
are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations
will not be verified by NPS. |
Authorized Official Telephone Number |
7543671698 |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
Healthcare Provider Taxonomy Code 1 |
372600000X |
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot
include a Post Office box. |
Healthcare Provider Primary Taxonomy Switch 1 |
N |
The city name in the location address of the provider being identified. |
Healthcare Provider Taxonomy Code 2 |
374U00000X |
The State code in the location of the provider
being identified. |
Healthcare Provider Primary Taxonomy Switch 2 |
Y |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Is Organization Subpart |
N |
The country code in the location address of the provider being identified. |
Healthcare Provider Taxonomy Group 1 |
193200000X MULTI-SPECIALTY GROUP |
The telephone number associated with the location address of the provider being identified. |
Healthcare Provider Taxonomy Group 2 |
193200000X MULTI-SPECIALTY GROUP |
The fax number associated with the location
address of the provider being identified. |