The Mary Sandoe House, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

230354 Issued in CO

Legal business name

THE MARY SANDOE HOUSE, INC

Practice address

1244 Gillaspie Dr
1242 Gillaspie Drive
Boulder, CO 80305-6600

Phone

(303) 494-7317

Fax

(303) 494-0653

NPI assigned

Nov 8, 2016

Organization subpart

No

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

Authorized official

Name

Miss Dorothy Marie Longobardi

Title

Director

Phone

(303) 494-7317

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1104368000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1244 GILLASPIE DR",
            "address_2": "1242 GILLASPIE DRIVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803056600",
            "telephone_number": "303-494-7317",
            "fax_number": "303-494-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 GILLASPIE DR",
            "address_2": "1242 GILLASPIE DRIVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803056600",
            "telephone_number": "303-494-7317",
            "fax_number": "303-494-0653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MARY SANDOE HOUSE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-08",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "LONGOBARDI",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "303-494-7317",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CO",
            "license": "230354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04181251",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Boulder, CO
• Providers in Boulder, CO by specialty
• Assisted Living Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.