Orchard Senior Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ORCHARD SENIOR LIVING LLC

Practice address

4287 Orchard St
Montclair, CA 91763-3023

Phone

(909) 399-4070

Fax

(855) 284-9979

NPI assigned

Nov 23, 2022

Last updated

Nov 23, 2022By 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

Miss Marydes Apolonio Guevarra

Title

Administrator

Phone

(213) 618-0938

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669161600000",
    "number": "1164132601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 CHESTNUT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900423735",
            "telephone_number": "213-618-0938",
            "fax_number": "855-399-4070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4287 ORCHARD ST",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917633023",
            "telephone_number": "909-399-4070",
            "fax_number": "855-284-9979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORCHARD SENIOR LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-23",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A",
        "authorized_official_last_name": "GUEVARRA",
        "authorized_official_first_name": "MARYDES",
        "authorized_official_middle_name": "APOLONIO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "213-618-0938",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "orchardseniorlivingllc@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4287 Orchard St",
            "city": "Montclair",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917633023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.