ACTIVE SENIOR LIVING RESIDENCE
NPI 1417371857
Assisted Living Facility in Tamarac, FL
About Active Senior Living Residence NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ACTIVE SENIOR LIVING RESIDENCE (NPI 1417371857) is a healthcare organization registered as an assisted living facility in Tamarac, Florida and active in the NPI registry since February 2014. The organization holds a CLIA Waiver certificate valid through October 21, 2026 and lists Beth Besu, Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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 10D0984256
Active Senior Living Residence · Tamarac, FLOther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Active Senior Living Residence's NPI number?
The NPI number for Active Senior Living Residence is 1417371857. It was assigned to this organization in the NPPES registry on February 5, 2014.
Where is Active Senior Living Residence located?
Active Senior Living Residence is located at 9057 NW 57th St, Tamarac, FL 33351. The listed phone number is (954) 721-1115.
What is Active Senior Living Residence's specialty?
The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.
Does Active Senior Living Residence hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 10D0984256) is associated with this NPI, valid through October 21, 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 Active Senior Living Residence was last updated on February 5, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Active Senior Living Residence · NPI 1417371857
Assisted Living Facility organization in Tamarac, Florida. Organization record, active in the CMS NPPES registry since February 5, 2014.
## Identity
- **NPI:** 1417371857 (Entity type: Organization)
- **Enumerated:** February 5, 2014
- **Primary specialty:** Assisted Living Facility · taxonomy 310400000X
- **Organization subpart:** No
- **Authorized official:** Beth Besu, ADMINISTRATOR
## Practice location
- **Address:** 9057 NW 57TH ST, Tamarac, FL 33351-4305
- **Phone:** (954) 721-1115
## Record status
- **NPPES last updated:** February 5, 2014
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1417371857) · Data from the CMS NPPES public registry.