The Elderly Inn, LLC

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

347003747 Issued in CA

Legal business name

THE ELDERLY INN, LLC

Practice address

4824 Livoti Ave
Fair Oaks, CA 95628-5008

Phone

(916) 806-2223

Fax

(916) 967-3099

NPI assigned

Dec 29, 2016

Organization subpart

No

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

Authorized official

Name

Sam Toplean

Title

Owner

Phone

(916) 806-2223

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1482969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482969600000",
    "number": "1063957041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4831 LIVOTI AVE",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956285007",
            "telephone_number": "916-806-2223",
            "fax_number": "916-967-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4824 LIVOTI AVE",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956285008",
            "telephone_number": "916-806-2223",
            "fax_number": "916-967-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ELDERLY INN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-29",
        "last_updated": "2016-12-29",
        "status": "A",
        "authorized_official_last_name": "TOPLEAN",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-806-2223"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "CA",
            "license": "347003747",
            "primary": true
        },
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "CA",
            "license": "347003754",
            "primary": false
        },
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "CA",
            "license": "347001289",
            "primary": false
        },
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "CA",
            "license": "347004184",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Custodial Care Facility in Fair Oaks, CA
• Providers in Fair Oaks, CA by specialty
• Custodial Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; 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.