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GREEN ACRES NPI 1396152963


NPI Information

NPI: 1396152963
Provider Name: GREEN ACRES
Classification: Assisted Living Facility - 3104A0625X
Entity Type: Organization

Specialization: Assisted Living, Mental Illness

Address:
15820 ARCHER ST
HUDSON, FL
ZIP 34667
Phone: (727) 861-2975
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GREEN ACRES is an assisted living and mental illness assisted living facility in Hudson, FL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. GREEN ACRES NPI is 1396152963. The provider is registered as an organization entity type.

The provider's business location address is:

15820 ARCHER ST
HUDSON, FL
ZIP 34667-816
Phone: (727) 861-2975
Fax: (727) 857-4533

The provider's authorized official is Luz T Kalbarczyk .
The authorized official title is Owner/adminstrator and has the following contact phone number (727) 861-2975.

The enumeration date for this NPI number is 7/16/2014 and was last updated on 1/20/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityAI8642FLORIDANo
23104A0625XAssisted Living FacilityAssisted Living, Mental IllnessAI8642FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1140906900MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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