Av Congregate Living

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

AV CONGREGATE LIVING

Practice address

4144 Vahan CT
Lancaster, CA 93536-6838

Phone

(661) 943-1262

NPI assigned

Aug 18, 2014

Organization subpart

No

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

Authorized official

Name

Jerrico Reyes

Title

President

Phone

(661) 943-1262

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1408320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408320000000",
    "number": "1306245105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4144 VAHAN COURT",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "93536",
            "telephone_number": "661-943-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4144 VAHAN CT",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935366838",
            "telephone_number": "661-943-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AV CONGREGATE LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-18",
        "last_updated": "2014-08-18",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "JERRICO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-943-1262"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; 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.