Addison Holdings, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ADDISON HOLDINGS, INC.

Doing business as

Hillside Manor at Mountains Edge

Practice address

9651 Trattoria St
Las Vegas, NV 89178-8262

Phone

(702) 485-1876

Fax

(702) 463-2836

NPI assigned

Nov 14, 2019

Last updated

Nov 14, 2019By 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

Mr. Allyn Francis Povilaitis

Title

President

Phone

(702) 860-4967

Specialties & licenses 1

Addresses

Other names 1

• Hillside Manor at Mountains Edge Doing business as

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573689600000",
    "number": "1194360040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9651 TRATTORIA ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891788262",
            "telephone_number": "702-485-1876",
            "fax_number": "702-463-2836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9651 TRATTORIA ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891788262",
            "telephone_number": "702-485-1876",
            "fax_number": "702-463-2836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDISON HOLDINGS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-11-14",
        "status": "A",
        "authorized_official_last_name": "POVILAITIS",
        "authorized_official_first_name": "ALLYN",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-860-4967",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hillside Manor at Mountains Edge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Assisted Living Facility in Nevada

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