Gahc3 Omaha NE Alf TRS Sub, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GAHC3 OMAHA NE ALF TRS SUB, LLC

Practice address

5710 S 108TH St
Omaha, NE 68137-3592

Phone

(402) 596-9033

NPI assigned

Jun 8, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Danny Prosky

Title

Authorized Representative

Phone

(949) 270-9200

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Fountain View Assisted Living and Special Memory Care Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1003296732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5710 S 108TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681373592",
            "telephone_number": "402-596-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5710 S 108TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681373592",
            "telephone_number": "402-596-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAHC3 OMAHA NE ALF TRS SUB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-08",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "PROSKY",
        "authorized_official_first_name": "DANNY",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "949-270-9200"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100253886-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fountain View Assisted Living and Special Memory Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caroline Lillian Gaglio
• Komi Stone Gaglozou
• Amber J Gagne, PLADC
• Kali Gagnon, DO
• Abla Gagnovi
• Gail F. Williams
• Dylan Christopher Gaillard, DDS
• Brianne Marie Gaines, OTD, OTR/L
• Cassey Marie Gaines
• David T Gaines, LMHP

• Assisted Living Facility in Omaha, NE
• Providers in Omaha, NE by specialty
• Assisted Living Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.