KIVA AT CANTERBURY,LLC
NPI 1164775953
Assisted Living Facility in Bonita Springs, FL

Active since October 18, 2012CLIA 10D2202304 · Waiver
10 7TH ST, BONITA SPRINGS, FL 34134(239) 992-8599 Get Directions Write a Review

NPPES record last updated: October 18, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Assisted Living Facility
  • CLIA Number: 10D2202304
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 11-24-2026

About KIVA AT CANTERBURY,LLC

This page provides the complete NPI Profile along with additional information for Kiva At Canterbury,llc, a provider established in Bonita Springs, Florida operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1164775953 assigned on October 2012. The practitioner's primary taxonomy code is 310400000X with license number AL7622 (FL). The provider is registered as an organization and their NPI record was last updated 14 years ago. The authorized official of this NPI record is Thomas Scarborough (Owner)

NPI
1164775953 Verify this NPI
Provider Name
KIVA AT CANTERBURY,LLC
Entity Type
Organization
Location Address
10 7TH ST BONITA SPRINGS, FL 34134
Location Phone
(239) 992-8599
Mailing Address
10 7TH ST BONITA SPRINGS, FL 34134
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-18-2012
Last Update Date
10-18-2012
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
License No.
AL7622
License State
FL
Taxonomy Description
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

THOMAS SCARBOROUGH

Authorized Official Title
OWNER
Authorized Official Phone
(615) 397-5271

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
693447100OTHER (01)FLMEDICAID WAIVER

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 this NPI number is:

CLIA Number
10D2202304
Facility Type
Assisted Living Facility
Certificate Effective Date
November 25, 2024
Certificate Expiration Date
November 24, 2026
Laboratory Director
CINDY DIGMAN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Kiva At Canterbury,llc 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.

Reviews for KIVA AT CANTERBURY,LLC

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Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Assisted Living Facility
10 7TH ST
BONITA SPRINGS, FL 34134

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164775953, enumerated as an "organization" on October 18, 2012.

The provider is located at 10 7TH ST BONITA SPRINGS, FL 34134 and the phone number is (239) 992-8599.

Assisted Living Facility with taxonomy code 310400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.