Ambrosia Senior Care LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

AMBROSIA SENIOR CARE LLC

Practice address

2310 Torch Lake Dr
Forney, TX 75126-2480

Phone

(512) 970-2880

NPI assigned

Jul 30, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Frederic Bushe Fiege

Title

Manager

Phone

(512) 970-2880

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1285243725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 TORCH LAKE DR",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751262480",
            "telephone_number": "512-970-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 TORCH LAKE DR",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751262480",
            "telephone_number": "512-970-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBROSIA SENIOR CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "FIEGE",
        "authorized_official_first_name": "FREDERIC",
        "authorized_official_middle_name": "BUSHE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "512-970-2880",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Forney, TX
• Providers in Forney, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.