NPIMap

Organization Active NPI

Good Old Days Home Care LLC

  • Adult Care Home Facility
  • Sparks, NV
National Provider Identifier
1356797955
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
7675AGC-3 Issued in NV
Legal business name
GOOD OLD DAYS HOME CARE LLC
Practice address
1255 Loma Verde CT
Sparks, NV 89436-0832
Phone
(775) 315-9503
NPI assigned
May 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2016

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

Authorized official

Name
Mr. Dietmar Ingensiep
Title
Administrator
Phone
(775) 315-9503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 7675AGC-3 NV Primary

Addresses

Primary practice location

1255 Loma Verde CT
Sparks, NV 89436-0832

Mailing address

2255 Wide Horizon Dr
Reno, NV 89509-5078
Phone (775) 315-9503

Other identifiers 1

IdentifierTypeStateIssuer
7675AGC-3OtherNVLICENSE NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Good Old Days Home Care LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463011200000",
    "number": "1356797955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 WIDE HORIZON DR",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895095078",
            "telephone_number": "775-315-9503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 LOMA VERDE CT",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894360832",
            "telephone_number": "775-315-9503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD OLD DAYS HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-12",
        "last_updated": "2016-05-12",
        "status": "A",
        "authorized_official_last_name": "INGENSIEP",
        "authorized_official_first_name": "DIETMAR",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "775-315-9503",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NV",
            "license": "7675AGC-3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "7675AGC-3",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; 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.