Castle Rock Assisted Living II, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CASTLE ROCK ASSISTED LIVING II, LLC

Practice address

1768 Rose Petal LN
Castle Rock, CO 80109-3588

Phone

(303) 815-9347

NPI assigned

Aug 30, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Jaime Enriques Sepulveda

Title

Owner

Phone

(303) 710-9088

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567123200000",
    "number": "1164070389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1768 ROSE PETAL LN",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801093588",
            "telephone_number": "303-815-9347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1768 ROSE PETAL LN",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801093588",
            "telephone_number": "303-815-9347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASTLE ROCK ASSISTED LIVING II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-30",
        "last_updated": "2019-08-30",
        "status": "A",
        "authorized_official_last_name": "SEPULVEDA",
        "authorized_official_first_name": "JAIME",
        "authorized_official_middle_name": "ENRIQUES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-710-9088",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149179",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cral@comcast.net",
            "affiliation": "N",
            "address_1": "1768 Rose Petal Ln",
            "city": "Castle Rock",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801093588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Assisted Living Facility in Castle Rock, CO
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• Assisted Living Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; 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.