Provider Demographics
NPI:1619271525
Name:NORTHPOINTE RETIREMENT COMMUNITY
Entity Type:Organization
Organization Name:NORTHPOINTE RETIREMENT COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-478-1114
Mailing Address - Street 1:5100 NORTHPOINTE PKWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-7844
Mailing Address - Country:US
Mailing Address - Phone:850-478-1114
Mailing Address - Fax:850-479-1301
Practice Address - Street 1:5100 NORTHPOINTE PKWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-7844
Practice Address - Country:US
Practice Address - Phone:850-478-1114
Practice Address - Fax:850-479-1301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7760310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL141014800Medicaid