Palos Verdes Care Cottage LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PALOS VERDES CARE COTTAGE LLC

Practice address

1808 Peninsula Verde Dr
Rancho Palos Verdes, CA 90275-1051

Phone

(562) 356-7130

NPI assigned

Apr 11, 2023

Organization subpart

No

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

Authorized official

Name

Ma. Salvacion Fabiana Medina

Title

Ceo

Phone

(562) 356-7130

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1407542707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 PENINSULA VERDE DR",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902751051",
            "telephone_number": "562-356-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 PENINSULA VERDE DR",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902751051",
            "telephone_number": "562-356-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALOS VERDES CARE COTTAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "MA. SALVACION",
        "authorized_official_middle_name": "FABIANA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-356-7130"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Rancho Palos Verdes, CA
• Providers in Rancho Palos Verdes, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.