OrganizationActive
A Banyan Residence Assisted Living LLC
NPI 1770775413 · Assisted Living Facility · Venice, FL
Provider details
- NPI number
- 1770775413
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Greg Anderson, Managing Member(954) 454-2345
- License
- APPLIED FOR IT (FL)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
100 Base Ave E
Venice, FL 34285-3809
Phone: (941) 412-4748
Street-level locationGet directions
Mailing address
3107 Ne 40th Ct
Fort Lauderdale, FL 33308-6413
Registry dates
- Enumerated
- 2007-08-16
- Last updated
- 2009-12-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.