Gahc4 West Haven Ut TRS Sub, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GAHC4 WEST HAVEN UT TRS SUB, LLC

Doing business as

Lotus Park Care Centers

Practice address

2639 W 3520 S
West Haven, UT 84401-8529

Phone

(801) 732-5290

NPI assigned

Dec 6, 2019

Last updated

Dec 10, 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

Danny Prosky

Title

President

Phone

(949) 270-9200

Specialties & licenses 1

Addresses

Other names 1

• Lotus Park Care Centers Doing business as

Tax ID family

Gahc4 West Haven Ut TRS Sub LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Gahc4 West Haven Ut TRS Sub, LLC

  dba Lotus Park Assisted Living

  • Assisted Living Facility
  • West Haven, UT
  • NPI 1063059939
  NPD tax ID

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

{
    "created_epoch": "1575590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575936000000",
    "number": "1194362327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18191 VON KARMAN AVE STE 300",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926127106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2639 W 3520 S",
            "city": "WEST HAVEN",
            "state": "UT",
            "postal_code": "844018529",
            "telephone_number": "801-732-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAHC4 WEST HAVEN UT TRS SUB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-06",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A",
        "authorized_official_last_name": "PROSKY",
        "authorized_official_first_name": "DANNY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-270-9200"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lotus Park Care Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Jo Fowers, FNP
• Karensa Fox
• Full Circle Counseling PLLC
• Futures Through Choices, Inc.
• Gahc4 West Haven Ut TRS Sub, LLC (Lotus Park Assisted Living)
• Bethany Garner
• Adam Comish Gilbert, PT, DPT
• Dennis Tracy Gilbert, PT
• Tyler Gill, LAT, ATC
• Alyxandria Gonzales

• Assisted Living Facility in West Haven, UT
• Providers in West Haven, UT by specialty
• Assisted Living Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.