GOOD SAM'S ASSISTED LIVING RESIDENCE, LLC
NPI 1538604764
Assisted Living Facility in Palm Coast, FL

Q: What is Good Sam's Assisted Living Residence, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since December 26, 2016

1 PEBBLE WOOD LN, PALM COAST, FL 32164(386) 447-8145 Get Directions Write a Review

NPPES record last updated: December 26, 2016. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Good Sam's Assisted Living Residence, Llc NPPES

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

GOOD SAM'S ASSISTED LIVING RESIDENCE, LLC (NPI 1538604764) is a healthcare organization registered as an assisted living facility in Palm Coast, Florida and active in the NPI registry since December 2016. The organization lists L. Judith Fermin-ostrin, Administrator, as its authorized official.

NPPES Registry Identity

NPI1538604764

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameGOOD SAM'S ASSISTED LIVING RESIDENCE, LLC

Location Address1 PEBBLE WOOD LNPalm Coast, FL 32164-7491

Mailing Address1 Pebble Wood LnPalm Coast, FL 32164-7491 · (386) 447-8145

Phone(386) 447-8145

Organization SubpartNo

Authorized OfficialL. Judith Fermin-ostrinAdministrator · (516) 524-6624

Enumeration DateDecember 26, 2016

✔ NPI 1538604764 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in FL · 10049

Definition

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.

1 PEBBLE WOOD LN, Palm Coast, FL 32164

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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 Good Sam's Assisted Living Residence, LLC's NPI number?

The NPI number for Good Sam's Assisted Living Residence, LLC is 1538604764. It was assigned to this organization in the NPPES registry on December 26, 2016.

Where is Good Sam's Assisted Living Residence, LLC located?

Good Sam's Assisted Living Residence, LLC is located at 1 Pebble Wood Ln, Palm Coast, FL 32164. The listed phone number is (386) 447-8145.

What is Good Sam's Assisted Living Residence, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Good Sam's Assisted Living Residence, LLC was last updated on December 26, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.