Ibbott17 LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

IBBOTT17 LLC

Practice address

302 Purcell Ave
Cincinnati, OH 45205-2244

Phone

(513) 407-7221

NPI assigned

Apr 19, 2024

Organization subpart

No

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

Authorized official

Name

Mayka Bailey

Title

Administrator

Phone

(513) 432-3835

Specialties & licenses 1

Addresses

Other names 1

• Nu Vida Residence Other name

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

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713484800000",
    "number": "1235984667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 PURCELL AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452052244",
            "telephone_number": "513-407-7221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 PURCELL AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452052244",
            "telephone_number": "513-407-7221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IBBOTT17 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "MAYKA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "513-432-3835"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nu Vida Residence",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Assisted Living Facility in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Assisted Living Facility in Ohio

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