2021 Boulevard Cohousing LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

2021 BOULEVARD COHOUSING LLC

Practice address

2021 Boulevard Rd SE
Olympia, WA 98501-3227

Phone

(360) 259-5000

Fax

(360) 357-7049

NPI assigned

Mar 19, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Daniel Irwin Stusser

Title

Managing Partner

Phone

(360) 259-5000

Specialties & licenses 1

Addresses

Other names 1

• 2021 Boulevard Doing business as

Locations

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1225898331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4008",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985010008",
            "telephone_number": "360-259-5000",
            "fax_number": "360-357-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 BOULEVARD RD SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985013227",
            "telephone_number": "360-259-5000",
            "fax_number": "360-357-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2021 BOULEVARD COHOUSING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "STUSSER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "IRWIN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "360-259-5000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "2021 Boulevard",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.