1811461262 NPI number — HOUSING AUTHORITY OF THE CITY OF KEY WEST, FLORIDA

Table of content: (NPI 1811461262)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811461262 NPI number — HOUSING AUTHORITY OF THE CITY OF KEY WEST, FLORIDA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOUSING AUTHORITY OF THE CITY OF KEY WEST, FLORIDA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
POINCIANA GARDENS SR. LIVING
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811461262
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/19/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1664 DUNLAP DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KEY WEST
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33040
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-864-4248
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1664 DUNLAP DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KEY WEST
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-864-4248
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/18/2019

Additional Information

Authorized Official

Authorized Official Last Name:
HERRINGTON
Authorized Official First Name:
NATALIE
Authorized Official Middle Name:
ELIZABETH
Authorized Official Title or Position:
PROGRAM ADMINISTRATOR # 171244642
Authorized Official Telephone Number:
305-440-3191

Provider Taxonomy Codes

  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 833097311 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 102440600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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