Family Care Assisted Living LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

23111U Issued in CO

Legal business name

FAMILY CARE ASSISTED LIVING LLC

Practice address

174 Edlun Rd
Grand Junction, CO 81503-2220

Phone

(970) 241-6379

Fax

(970) 314-9697

NPI assigned

Dec 8, 2016

Last updated

Dec 8, 2016By 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. Sam L Hean, BANPI 1417321050

Title

Owner

Phone

(970) 210-0292

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sam Hean

  • Personal Care Attendant
  • Clifton, CO
  • NPI 1417321050
  Authorized official Same address or phone

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

{
    "created_epoch": "1481155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481155200000",
    "number": "1215471370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 RIVER RIDGE DR",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815033421",
            "telephone_number": "970-210-0292",
            "fax_number": "970-314-9697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 EDLUN RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815032220",
            "telephone_number": "970-241-6379",
            "fax_number": "970-314-9697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-08",
        "last_updated": "2016-12-08",
        "status": "A",
        "authorized_official_last_name": "HEAN",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-210-0292",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "CO",
            "license": "23111U",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Mental Illness) in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Assisted Living Facility (Mental Illness) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.