STILLWATER ASSISTED LIVING LLC NPI 1366112914

NPI Information

NPI: 1366112914
Provider Name: STILLWATER ASSISTED LIVING, LLC
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
12413 RIVERGLEN DR
RIVERVIEW, FL
ZIP 33569
Phone: (813) 398-3000
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STILLWATER ASSISTED LIVING, LLC is an assisted living facility in Riverview, 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. STILLWATER ASSISTED LIVING, LLC NPI is 1366112914. The provider is registered as an organization entity type.

The provider's business location address is:

12413 RIVERGLEN DR
RIVERVIEW, FL
ZIP 33569-213
Phone: (813) 398-3000

The provider's authorized official is Ryan Sharpe .
The authorized official title is Owner and has the following contact phone number (865) 816-7433.

The enumeration date for this NPI number is 9/15/2021 and was last updated on 9/15/2021.

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				Yes

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	110588200	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: 5/5/2024

NPI Synchronization or Removal

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