GREENBRIAR RETIREMENT NPI 1023294899

Assisted Living Facility in Apopka, FL

NPI 1023294899 Organization Assisted Living Facility CLIA Number 10D2205368 CLIA Certificate of Waiver

About GREENBRIAR RETIREMENT

Greenbriar Retirement is a provider established in Apopka, Florida specializing in assisted living facility. The NPI number of Greenbriar Retirement is 1023294899 and was assigned on January 2008. The practitioner's primary taxonomy code is 310400000X with license number AL9202 (FL). The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Mrs. Corazon M. Bagsiyao R.n. (Administrator)

The CLIA number of Greenbriar Retirement is 10D2205368 registered as a "assisted living facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Greenbriar Retirement to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1023294899

Provider NameGREENBRIAR RETIREMENT
Provider Location Address3615 MCNEIL RD APOPKA, FL 32703
Provider Mailing Address3615 MCNEIL RD APOPKA, FL 32703
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date01-11-2008
Last Update Date01-11-2008


Primary Taxonomy

Taxonomy Code310400000X
ClassificationAssisted Living Facility
TypeNursing & Custodial Care Facilities
License No.AL9202
License StateFL
Taxonomy DescriptionA 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.

Business Address

GREENBRIAR RETIREMENT
3615 MCNEIL RD
APOPKA, FL
ZIP 32703
Phone: (407) 433-6424
Fax: (407) 521-2901

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Mailing Address

GREENBRIAR RETIREMENT
3615 MCNEIL RD
APOPKA, FL
ZIP 32703
Phone: (407) 433-6424
Fax: (407) 521-2901



Authorized Official

Authorized Official NameMRS. CORAZON M. BAGSIYAO R.N.
Authorized Official TitleADMINISTRATOR
Authorized Official Phone(407) 433-6424

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1023294899 is:

CLIA Number10D2205368
Facility TypeASSISTED LIVING FACILITY
Certificate TypeCertificate of Waiver

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
689265500MEDICAID (05)FL

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1497090997BAGSIYAO CORPORATION
Organization
Assisted Living Facility3615 MCNEIL RD
APOPKA, FL 32703
(407) 883-0643

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The 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 Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type 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 (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.