Esl SD Victorian Operations LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

11035 Issued in SD

Legal business name

ESL SD VICTORIAN OPERATIONS LLC

Doing business as

The Victorian

Practice address

1321 Columbus St
Rapid City, SD 57701-2505

Phone

(605) 342-1913

Fax

(605) 348-2078

NPI assigned

Jun 20, 2018

Organization subpart

No

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

Authorized official

Name

Brian R Uhlir

Title

Cfo

Phone

(530) 242-8300

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Victorian Doing business as

Locations

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1245724509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2334 WASHINGTON AVE STE A",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012159",
            "telephone_number": "530-242-8300",
            "fax_number": "530-244-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 COLUMBUS ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577012505",
            "telephone_number": "605-342-1913",
            "fax_number": "605-348-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESL SD VICTORIAN OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-20",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "UHLIR",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "530-242-8300"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SD",
            "license": "11035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "310400000X",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Victorian",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Victorian",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Assisted Living Facility in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.