NPIMap

Organization Active NPI

Assisted Living Concepts Inc

Doing business as Clark House

  • Assisted Living Facility
  • Moscow, ID
National Provider Identifier
1275729931
Registry record updated Sep 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
RC558 Issued in ID
Legal business name
ASSISTED LIVING CONCEPTS INC
Doing business as
Clark House
Practice address
1401 N Polk St
Moscow, ID 83843
Phone
(208) 882-3438
NPI assigned
Sep 17, 2007
Last updated
Sep 17, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2007

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

Authorized official

Name
Walter A Levonowich
Title
Vice President Controller
Phone
(262) 250-4500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X RC558 ID Primary

Addresses

Primary practice location

1401 N Polk St
Moscow, ID 83843

Mailing address

W140 N8981 Lilly Road
Menomonee Falls, WI 53051-2325
Phone (262) 250-4500

Other names 1

  • Clark House Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Assisted Living Concepts Inc213 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 8

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1189987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189987200000",
    "number": "1275729931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W140 N8981 LILLY ROAD",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530512325",
            "telephone_number": "262-250-4500",
            "fax_number": "262-251-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 N POLK ST",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "83843",
            "telephone_number": "208-882-3438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSISTED LIVING CONCEPTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-17",
        "last_updated": "2007-09-17",
        "status": "A",
        "authorized_official_last_name": "LEVONOWICH",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT CONTROLLER",
        "authorized_official_telephone_number": "262-250-4500"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "ID",
            "license": "RC558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clark House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moscow, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2007; 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.