GRAND VILLA OF DEERFIELD BEACH
NPI 1700239563
Assisted Living Facility in Deerfield Beach, FL

NPI Status: Active since July 18, 2016

Contact Information

1050 SW 24TH AVE
DEERFIELD BEACH, FL
ZIP 33442
Phone: (954) 360-7667
Fax: (954) 360-7363

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 10D1044756
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 02-13-2026

About GRAND VILLA OF DEERFIELD BEACH

This page provides the complete NPI Profile along with additional information for Grand Villa Of Deerfield Beach, a provider established in Deerfield Beach, Florida operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1700239563 assigned on July 2016. The practitioner's primary taxonomy code is 310400000X with license number AL# 8697 (FL). The provider is registered as an organization and their NPI record was last updated 9 years ago. The provider's is doing business as Grand Villa Of Deerfield Beach. The authorized official of this NPI record is Johnny Sizemore (Operations Coordinator)

NPI
1700239563
Provider Legal Name
GV DEERFIELD BEACH, LLC
Other Organization Name
GRAND VILLA OF DEERFIELD BEACH
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
1050 SW 24TH AVE DEERFIELD BEACH, FL 33442
Location Phone
(954) 360-7667
Location Fax
(954) 360-7363
Mailing Address
13770 58TH ST N SUITE 312 CLEARWATER, FL 33760
Mailing Phone
(727) 726-3980
Mailing Fax
(954) 360-7363
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-18-2016
Last Update Date
07-18-2016
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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.
AL# 8697
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
13104A0625XNursing & Custodial Care Facilities

Assisted Living Facility
Assisted Living, Mental Illness

AL# 8697 (FL)

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

JOHNNY SIZEMORE

Authorized Official Title
OPERATIONS COORDINATOR
Authorized Official Phone
(727) 726-3980

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
10D1044756
Facility Type
Assisted Living Facility
Certificate Effective Date
February 14, 2024
Certificate Expiration Date
February 13, 2026
Laboratory Director
FELECIA FISHER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Grand Villa Of Deerfield Beach 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.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1700239563
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
27004318512
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 0 + 0 + 4 + 3 + 1 + 8 + 5 + 1 + 2 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1700239563 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


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

NPI Name / Type Taxonomy Address
1891263141SOLARIS REHAB, LLC
Organization
Clinic/Center (Rehabilitation)1050 SW 24TH AVE
DEERFIELD BEACH, FL 33442
(954) 361-5502

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1700239563, enumerated in the NPI registry as an "organization" on July 18, 2016

The provider is located at 1050 Sw 24th Ave Deerfield Beach, Fl 33442 and the phone number is (954) 360-7667

This medical organization specializes in Assisted Living Facility with taxonomy code 310400000X

The provider's CLIA number is 10D1044756 for a "assisted living facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued 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..

This NPI record was last updated on July 18, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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