Coastside Convalescent Associates LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

415600502 Issued in CA

Legal business name

COASTSIDE CONVALESCENT ASSOCIATES LLC

Doing business as

Three Bells of Montara

Practice address

1186 Acacia Street
Montara, CA 94037-1252

Phone

(650) 728-5483

Fax

(650) 728-8649

NPI assigned

Nov 25, 2014

Last updated

Nov 25, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Sharolyn Kriger

Title

Administrator

Phone

(650) 728-5483

Specialties & licenses 1

Addresses

Other names 1

• Three Bells of Montara Doing business as

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416873600000",
    "number": "1134526783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1186 ACACIA STREET",
            "city": "MONTARA",
            "state": "CA",
            "postal_code": "940371252",
            "telephone_number": "650-728-5483",
            "fax_number": "650-728-8649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1186 ACACIA STREET",
            "city": "MONTARA",
            "state": "CA",
            "postal_code": "940371252",
            "telephone_number": "650-728-5483",
            "fax_number": "650-728-8649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTSIDE CONVALESCENT ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-25",
        "last_updated": "2014-11-25",
        "status": "A",
        "authorized_official_last_name": "KRIGER",
        "authorized_official_first_name": "SHAROLYN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "650-728-5483",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "415600502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Three Bells of Montara",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sandra Goss Calman, MD
• Steven B Groubert, O.D.
• Jessica Hale, RN, MS
• Lillian Hansen
• Matt Keck, MFT
• Leora Lerba

• Assisted Living Facility in Montara, CA
• Providers in Montara, 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 Nov 25, 2014; 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.