Parkside Adult Family Home LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PARKSIDE ADULT FAMILY HOME LLC

Practice address

1702 S Highlands Blvd # a
West Richland, WA 99353-6778

Phone

(168) 241-0388

NPI assigned

May 1, 2023

Last updated

May 1, 2023By 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

Ms. Judith K Nyaribo, BSN,RNNPI 1477048619

Title

Manager

Phone

(168) 241-0388

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

• Judith K Nyaribo

  • Registered Nurse
  • Arlington, TX
  • NPI 1477048619
  NPD Authorized official

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682899200000",
    "number": "1265121800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 S HIGHLANDS BLVD # A",
            "city": "WEST RICHLAND",
            "state": "WA",
            "postal_code": "993536778",
            "telephone_number": "168-241-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 S HIGHLANDS BLVD # A",
            "city": "WEST RICHLAND",
            "state": "WA",
            "postal_code": "993536778",
            "telephone_number": "168-241-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE ADULT FAMILY HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A",
        "authorized_official_last_name": "NYARIBO",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "168-241-0388",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BSN,RN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John M Olsen, MD
• Sierra Orr, LM, CPM
• Valerie Alexis Ortiz, LMT
• Ryan Glenn Ostler, DO
• Paradise Family Dental (Family First Dental)
• Penttila Schroeder Maxfield,DDS, PS (West Richland Family Dental Center)
• Wayne Fletcher Penttila, DDS
• Robert Harvey Perkes, DC
• Nicole Maree Petersen, ARNP
• Devin Marie Ramsay

• Skilled Nursing Facility in West Richland, WA
• Providers in West Richland, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.