Pacifica Senior Living Milton LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PACIFICA SENIOR LIVING MILTON LLC

Doing business as

Meridian At Stone Creek

Practice address

1111 S 376TH St
Milton, WA 98354-5501

Phone

(253) 661-3651

NPI assigned

Oct 22, 2020

Organization subpart

No

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

Authorized official

Name

Deepak Israni

Title

Owner

Phone

(619) 296-9000

Specialties & licenses 1

Addresses

Other names 1

• Meridian At Stone Creek Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603324800000",
    "number": "1063011880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 S 376TH ST",
            "city": "MILTON",
            "state": "WA",
            "postal_code": "983545501",
            "telephone_number": "253-661-3651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 S 376TH ST",
            "city": "MILTON",
            "state": "WA",
            "postal_code": "983545501",
            "telephone_number": "253-661-3651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFICA SENIOR LIVING MILTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-22",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A",
        "authorized_official_last_name": "ISRANI",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-296-9000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meridian At Stone Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Omwando Omare
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• Melanie Sandoval Orencia, M.D.
• Mallory Ostberg
• Dawn Kelly Owens, LMP
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• Pathways Consulting Services, LLC
• Breauna Pederson

• Assisted Living Facility in Milton, WA
• Providers in Milton, WA by specialty
• Assisted Living Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.