Senior Living Community an Eastern Star Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

306000889 Issued in CA

Legal business name

SENIOR LIVING COMMUNITY AN EASTERN STAR HOME

Practice address

16850 Bastanchury Rd
Yorba Linda, CA 92886-1608

Phone

(714) 577-9281

Fax

(714) 577-9854

NPI assigned

Sep 6, 2017

Last updated

Jul 21, 2022By 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

Mr. Jim Whiteley

Title

Chairman of the Board

Phone

(707) 696-7389

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1285152629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16850 BASTANCHURY RD",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928861608",
            "telephone_number": "714-577-9281",
            "fax_number": "714-577-9854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16850 BASTANCHURY RD",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928861608",
            "telephone_number": "714-577-9281",
            "fax_number": "714-577-9854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR LIVING COMMUNITY AN EASTERN STAR HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-06",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WHITELEY",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "CHAIRMAN OF THE BOARD",
        "authorized_official_telephone_number": "707-696-7389",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "306000889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Yorba Linda, CA
• Providers in Yorba Linda, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.