Village Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

S0170 Issued in IA

Legal business name

VILLAGE ASSISTED LIVING LLC

Practice address

3000 W Madison Ave
Fairfield, IA 52556-4205

Phone

(641) 469-5778

Fax

(641) 469-4529

NPI assigned

Mar 21, 2011

Last updated

Mar 21, 2011By 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. James Elliott

Title

Owner

Phone

(319) 795-8800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300665600000",
    "number": "1225337975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 W MADISON AVE",
            "city": "FAIRFIELD",
            "state": "IA",
            "postal_code": "525564205",
            "telephone_number": "641-469-5778",
            "fax_number": "641-469-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 W MADISON AVE",
            "city": "FAIRFIELD",
            "state": "IA",
            "postal_code": "525564205",
            "telephone_number": "641-469-5778",
            "fax_number": "641-469-4529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-21",
        "last_updated": "2011-03-21",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-795-8800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IA",
            "license": "S0170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Fairfield, IA
• Providers in Fairfield, IA by specialty
• Assisted Living Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2011; 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.