IMMANUEL AT YBOR ASSISTED LIVING FACILITY – NPI #1063836781
Skilled Nursing Facility

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

IMMANUEL AT YBOR ASSISTED LIVING FACILITY is a skilled nursing facility (SNF) located in TAMPA, FL. NPPES has assigned the NPI number 1063836781 to IMMANUEL AT YBOR ASSISTED LIVING FACILITY on February 17, 2014. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “IMMANUEL AT YBOR ASSISTED LIVING FACILITY” is a dba name, the actual legal business name for this organization is YETEY ENTERPRISES INC. This provider is also associated with 2 additional names listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 314000000X from the Health Care Provider Taxonomy code set, which is classified as Skilled Nursing Facility.

The NPI profile was previously updated about 6 years ago on Apr 17, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for IMMANUEL AT YBOR ASSISTED LIVING FACILITY below.

NPI Profile for
YETEY ENTERPRISES INC

NPI Number
1063836781
Enumeration Date

(more than 12 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
YETEY ENTERPRISES INC
Doing Business As (dba): IMMANUEL AT YBOR ASSISTED LIVING FACILITY
Other name(s)
All associated names:
Doing Business As (dba)
IMMANUEL AT YBOR ASSISTED LIVING FACILITY
Doing Business As (dba)
YETEY ALF,SPRINGSWATER ALF AND IMMANUEL AT YBOR ALF
Primary location
3213 E 11TH AVE
TAMPA, FL 33605
Phone: (813) 247-5852 Fax:
Mailing address
8602 N 22ND ST
TAMPA, FL 33604-2104
Phone: (813) 930-8370 Fax:
Organization Subpart
No
Authorized Official
ABIODUN ADEGBOLA
ADMINISTRATOR
Phone: (813) 247-5852
Updated
Certification Date
Apr 17, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for IMMANUEL AT YBOR ASSISTED LIVING FACILITY

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDFL005550800
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
314000000X
- Skilled Nursing Facility (Primary)
3104A0625X
- Assisted Living Facility / Assisted Living, Mental Illness
FL AL10756

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.