Good Samaritan Independent Living Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

034533 Issued in MO

Legal business name

GOOD SAMARITAN INDEPENDENT LIVING INC

Doing business as

CAPE ALBEON

Practice address

3300 Lake Bend Dr
Valley Park, MO 63088-2524

Phone

(636) 861-3200

Fax

(636) 861-6073

NPI assigned

Jul 26, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Carol Elizabeth Disanza, MA LB HA

Title

Executive Director

Phone

(636) 861-3200

Specialties & licenses 1

Addresses

Other names 1

• CAPE ALBEON Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1376733204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 LAKE BEND DR",
            "city": "VALLEY PARK",
            "state": "MO",
            "postal_code": "630882524",
            "telephone_number": "636-861-3200",
            "fax_number": "636-861-6073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 LAKE BEND DR",
            "city": "VALLEY PARK",
            "state": "MO",
            "postal_code": "630882524",
            "telephone_number": "636-861-3200",
            "fax_number": "636-861-6073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN INDEPENDENT LIVING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "DISANZA",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "636-861-3200",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA LB HA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "034533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAPE ALBEON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Danielle Nicole Critzas
• Justin Keith Croft
• Amy Jane Devore, LPC
• Robert Edminston, D.C.
• Garden View Care Center of St. Louis, Inc.
• Deborah Harre
• Abby Herrick
• Joan Ji-Young Hong, D.D.S.
• Laura Maxine Hoover, D.M.D.
• Laurel Hubster

• Assisted Living Facility in Valley Park, MO
• Providers in Valley Park, MO by specialty
• Assisted Living Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.