NPIMap

Organization Active NPI

Altrus LLC

  • Assisted Living Facility
  • Statesboro, GA
National Provider Identifier
1306102124
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
ALTRUS LLC
Practice address
115 Dodd Cir
Statesboro, GA 30461-0628
Phone
(912) 629-4083
NPI assigned
Apr 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Authorized official

Name
Joseph Bonaccorsi
Title
Chief Legal Officer
Phone
(312) 762-9999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

115 Dodd Cir
Statesboro, GA 30461-0628

Mailing address

33 S State St FL 5
Chicago, IL 60603-2804
Phone (312) 762-9999

Other identifiers 1

IdentifierTypeStateIssuer
767715870BMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Altrus LLC14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

115 Dodd Cir
Statesboro, GA 30461
Phone (912) 629-4083

NPI Registry JSON

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663113600000",
    "number": "1306102124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 S STATE ST FL 5",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606032804",
            "telephone_number": "312-762-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 DODD CIR",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304610628",
            "telephone_number": "912-629-4083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTRUS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-05",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A",
        "authorized_official_last_name": "BONACCORSI",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "312-762-9999"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767715870B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.