Gabriel Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

23L573 Issued in CO

Legal business name

GABRIEL ASSISTED LIVING

Practice address

5235 S Liverpool Way
Centennial, CO 80015-6425

Phone

(303) 954-0531

NPI assigned

Aug 16, 2016

Last updated

Aug 16, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gomgom SiregarNPI 1043664907

Title

Owner

Phone

(720) 998-6372

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gomgom Siregar

  • Home Health Aide
  • Centennial, CO
  • NPI 1043664907
  NPD (past) Authorized official
• Erlin Siregar

  • Community Health Worker
  • Centennial, CO
  • NPI 1154775013
  NPD (past)

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471305600000",
    "number": "1376098608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5235 S LIVERPOOL WAY",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800156425",
            "telephone_number": "303-954-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5235 S LIVERPOOL WAY",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800156425",
            "telephone_number": "303-954-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GABRIEL ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-16",
        "last_updated": "2016-08-16",
        "status": "A",
        "authorized_official_last_name": "SIREGAR",
        "authorized_official_first_name": "GOMGOM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-998-6372"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CO",
            "license": "23L573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PROVIDER NUMBER",
            "identifier": "87637065",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas E Funt, PHD
• Caroline Furtak
• Fusion Home Care, LLC
• Aaron Fyalka, DPT
• Gretchen Jane Gabbert-Downs, PH.D, CCC-SLP
• Sonia Gallego-Cubillos, DMD
• Gallegos Healthcare Partners, Inc (Right At Home Denver Metro)
• Patricia Gallegos, LPC
• Bernadette Nicole Galvez, RBT, BBA
• Richard Gamuac, M.D.

• Assisted Living Facility in Centennial, CO
• Providers in Centennial, CO by specialty
• Assisted Living Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.