Anaheim Villa Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ANAHEIM VILLA INC.

Doing business as

Anaheim Villa

Practice address

3411 W Ball Rd
Anaheim, CA 92804-3720

Phone

(714) 821-9660

NPI assigned

Sep 15, 2023

Organization subpart

No

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

Authorized official

Name

Hyoung T Park

Title

Ceo

Phone

(213) 700-0553

Specialties & licenses 1

Addresses

Other names 1

• Anaheim Villa Doing business as

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694736000000",
    "number": "1114705787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 N HARVARD BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900044319",
            "telephone_number": "213-700-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 W BALL RD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043720",
            "telephone_number": "714-821-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANAHEIM VILLA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "HYOUNG",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-700-0553"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anaheim Villa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.