NPIMap

Organization Active NPI

Summerville at Cobbco, Inc.

  • Assisted Living Facility
  • Garden Grove, CA
National Provider Identifier
1407185127
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
306000831 Issued in CA
Legal business name
SUMMERVILLE AT COBBCO, INC.
Doing business as
Brookdale Garden Grove
Emeritus at Garden Manor
Practice address
10200 Chapman Ave
Garden Grove, CA 92840-2858
Phone
(714) 636-6453
Fax
(714) 636-0978
NPI assigned
Dec 8, 2009
Organization subpart
Yes
Parent organization
BROOKDALE SENIOR LIVING INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Authorized official

Name
Joanne Leskowicz
Title
Senior Vice President
Phone
(414) 918-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 306000831 CA Primary

Addresses

Primary practice location

10200 Chapman Ave
Garden Grove, CA 92840-2858

Mailing address

10200 Chapman Ave
Garden Grove, CA 92840-2858
Phone (714) 636-6453

Other names 2

  • Brookdale Garden Grove Doing business as
  • Emeritus at Garden Manor Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2215464Brookdale Garden Grove10200 Chapman Ave, Garden Grove, CA 92840Certificate of waiverMar 2, 2027

National Provider Directory

National Provider Directory
Tax ID family
Summerville at Cobbco Inc18 organizations share this tax ID, including this one
Part of
Brookdale Senior Living Inc

Other organizations with this tax ID 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1407185127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 CHAPMAN AVE",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928402858",
            "telephone_number": "714-636-6453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 CHAPMAN AVE",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928402858",
            "telephone_number": "714-636-6453",
            "fax_number": "714-636-0978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERVILLE AT COBBCO, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROOKDALE SENIOR LIVING INC",
        "enumeration_date": "2009-12-08",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "LESKOWICZ",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "414-918-5000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "306000831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Garden Grove",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Emeritus at Garden Manor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Emeritus at Garden Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.