Imagine Supported Living Services

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

IMAGINE SUPPORTED LIVING SERVICES

Practice address

9065 Soquel Dr
Aptos, CA 95003-4001

Phone

(831) 464-8355

Fax

(831) 464-8658

NPI assigned

Aug 14, 2007

Organization subpart

No

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

Authorized official

Name

Douglas Pascover

Title

Executive Director

Phone

(831) 464-8355

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Imagine Supported Living Other name

Locations

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610928000000",
    "number": "1356533244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9065 SOQUEL DR",
            "city": "APTOS",
            "state": "CA",
            "postal_code": "950034001",
            "telephone_number": "831-464-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9065 SOQUEL DR",
            "city": "APTOS",
            "state": "CA",
            "postal_code": "950034001",
            "telephone_number": "831-464-8355",
            "fax_number": "831-464-8658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE SUPPORTED LIVING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A",
        "authorized_official_last_name": "PASCOVER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "831-464-8355"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HCB00012F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imagine Supported Living",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Roy Emery Howard, D.D.S.
• Jennifer Hubbs, MSW, LCSW
• Megan Eileen-Crowley Huggett
• Susan Frances Hughmanick, M.D.
• Christopher Philip Huynh, PHARMD
• Shannon Michelle Innis-Gielissen, CMP, AIMI, CYI
• Intuitive Health Management and Physical Therapy Inc
• Sidney Elizabeth Irving, FNP-C
• Marsha Isaacson
• Alison Kate Jackson, DDS

• Case Management Agency in Aptos, CA
• Providers in Aptos, CA by specialty
• Case Management Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; 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.