TODD CHANCELLOR NPI 1134603129

NPI Information

NPI: 1134603129
Provider Name: TODD CHANCELLOR
Classification: Assisted Living Facility - 310400000X
Entity Type: Individual
Address:
808 S BROADWAY
LANTANA, FL
ZIP 33462
Phone: (561) 797-7203
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Todd Chancellor is an assisted living facility in Lantana, FL. The provider is 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. Todd Chancellor NPI is 1134603129. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

808 S BROADWAY
LANTANA, FL
ZIP 33462-400
Phone: (561) 797-7203
Fax: (561) 797-3014

The enumeration date for this NPI number is 9/17/2018 and was last updated on 5/18/2020.

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
1	310400000X	Assisted Living Facility		AL12699	FLORIDA	Yes
2	310400000X	Assisted Living Facility				No

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
1	105771000	MEDICAID	FLORIDA

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: 4/28/2024

NPI Synchronization or Removal

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