Gahc3 Laporte in Alf TRS Sub, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GAHC3 LAPORTE IN ALF TRS SUB, LLC

Practice address

2002 Andrew Ave
La Porte, IN 46350-6563

Phone

(317) 324-9564

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 1

Addresses

Other names 1

• Brentwood at LaPorte 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": "1043690787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 ANDREW AVE",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463506563",
            "telephone_number": "317-324-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 ANDREW AVE",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463506563",
            "telephone_number": "317-324-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAHC3 LAPORTE IN 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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brentwood at LaPorte",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel W. Fridh, D.D.S., M.A.G.D.
• Erin E Fry
• Brian C. Fryar, DDS.,M.S.D.
• Setri S Fugar, M.D.
• Futures Case Management
• Stacey Rene Garcelon, M.ED. LMHCA, NCC
• Stephanie Anne Gehlhausen, MSPT
• Genuwin Health Inc
• Carrie Nicole Georgion, PHARM D, BSPS, BS, B
• Rachel Gerick

• All providers in La Porte, IN
• Assisted Living Facility in Indiana

• 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.