PALMS VILLA
NPI 1083866818
Assisted Living Facility - Assisted Living, Mental Illness in Oakland Park, FL

Q: What is Palms Villa Retirement Home, Inc.'s NPI number?

The NPI number for Palms Villa Retirement Home, Inc. is 1083866818. It was assigned to this organization in the NPPES registry on October 10, 2008. The provider is doing business as Palms Villa and Palms Villa Retirement Home.

Q: What is Palms Villa Retirement Home, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Mental Illness, with taxonomy code 3104A0625X.

Active since October 10, 2008CLIA 10D2201101 · Waiver

2131 NW 28TH ST, OAKLAND PARK, FL 33311(954) 484-1350(954) 527-0505 Get Directions Write a Review

NPPES record last updated: August 26, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 26, 2020, Jan 24, 2019 (2 updates tracked since 2019).

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About Palms Villa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PALMS VILLA (NPI 1083866818) is a healthcare organization registered as an assisted living, mental illness in Oakland Park, Florida and active in the NPI registry since October 2008. The organization holds a CLIA Waiver certificate valid through November 17, 2026 and lists Jason Kissoonlal, President, as its authorized official.

NPPES Registry Identity

NPI1083866818

Entity TypeOrganization

Primary Taxonomy3104A0625X

Legal Business NamePALMS VILLA RETIREMENT HOME, INC.

Location Address2131 NW 28TH STOakland Park, FL 33311-2136

Mailing Address2131 Nw 28th StOakland Park, FL 33311-2136 · (954) 484-1350 · Fax (954) 527-0505

Phone(954) 484-1350

Fax(954) 527-0505

Organization SubpartNo

Authorized OfficialJason KissoonlalPresident · (954) 484-1350

Enumeration DateOctober 10, 2008

Last NPPES UpdateAugust 26, 20202 updates tracked since enumeration

NPPES CertifiedAugust 26, 2020

✔ NPI 1083866818 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living Facility · Assisted Living, Mental IllnessNursing & Custodial Care Facilities

Taxonomy Code3104A0625X

License✔ Licensed in FL · AL4990

Definition

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.

2131 NW 28TH ST, Oakland Park, FL 33311

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Other Names 2

Doing Business AsPalms Villa

Doing Business AsPalms Villa Retirement Home

Other Identifiers 1

Medicaid140622100FL

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2201101

Palms Villa · Oakland Park, FL

Active · expires Nov 17, 2026

CLIA Number10D2201101

Laboratory TypeAssisted Living Facility

Certificate Effective DateNovember 18, 2024

Certificate Expiration DateNovember 17, 2026

Laboratory DirectorJason Kissoonial

Laboratory Phone(954) 523-1543

Laboratory LocationPalms Villa2131 NW 28th St, Oakland Park, FL 33311

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Palms Villa Retirement Home, Inc.'s NPI number?

The NPI number for Palms Villa Retirement Home, Inc. is 1083866818. It was assigned to this organization in the NPPES registry on October 10, 2008. The provider is doing business as Palms Villa and Palms Villa Retirement Home.

Where is Palms Villa Retirement Home, Inc. located?

Palms Villa Retirement Home, Inc. is located at 2131 NW 28th St, Oakland Park, FL 33311. The listed phone number is (954) 484-1350.

What is Palms Villa Retirement Home, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Mental Illness, with taxonomy code 3104A0625X.

Does Palms Villa Retirement Home, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2201101) is associated with this NPI, valid through November 17, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Palms Villa Retirement Home, Inc. was last updated on August 26, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.