Crown Point Village, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

12519 Issued in WI

Legal business name

CROWN POINT VILLAGE, LLC

Practice address

881 Liberty Boulevard
Sun Prairie, WI 53590

Phone

(608) 834-2073

Fax

(608) 834-2089

NPI assigned

Oct 21, 2008

Last updated

Oct 21, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Donald Simonson

Title

Executive Manager

Phone

(608) 318-1180

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224547200000",
    "number": "1043462021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1255",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535906255",
            "telephone_number": "608-318-1180",
            "fax_number": "608-318-0878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "881 LIBERTY BOULEVARD",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "53590",
            "telephone_number": "608-834-2073",
            "fax_number": "608-834-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWN POINT VILLAGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-21",
        "status": "A",
        "authorized_official_last_name": "SIMONSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "EXECUTIVE MANAGER",
        "authorized_official_telephone_number": "608-318-1180"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WI",
            "license": "12519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Sun Prairie, WI
• Providers in Sun Prairie, WI by specialty
• Assisted Living Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; 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.