NPIMap

Organization Active NPI

Autumn Park Assisted Living LLC

  • Assisted Living Facility
  • Washington, UT
National Provider Identifier
1154951572
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
AUTUMN PARK ASSISTED LIVING LLC
Practice address
548 N 1100 E
Washington, UT 84780-2980
Phone
(435) 275-4458
NPI assigned
Jan 24, 2020
Last updated
Apr 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Authorized official

Name
Chris Holub
Title
Administrator
Phone
(435) 275-4458

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

548 N 1100 E
Washington, UT 84780-2980

Mailing address

548 N 1100 E
Washington, UT 84780-2980
Phone (435) 275-4458

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586822400000",
    "number": "1154951572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 N 1100 E",
            "city": "WASHINGTON",
            "state": "UT",
            "postal_code": "847802980",
            "telephone_number": "435-275-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 N 1100 E",
            "city": "WASHINGTON",
            "state": "UT",
            "postal_code": "847802980",
            "telephone_number": "435-275-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTUMN PARK ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-24",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A",
        "authorized_official_last_name": "HOLUB",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "435-275-4458"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; 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.