BLC Mirage Inn, L.P.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BLC MIRAGE INN, L.P.

Practice address

72750 Country Club Dr
Rancho Mirage, CA 92270-4083

Phone

(760) 346-7772

NPI assigned

Aug 2, 2024

Organization subpart

No

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

Authorized official

Name

Anna Munoz

Title

Assistant Secretary

Phone

(414) 918-5443

Specialties & licenses 1

Addresses

Other names 1

• Brookdale Mirage Inn Doing business as

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

{
    "created_epoch": "1722556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1407686702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72750 COUNTRY CLUB DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704083",
            "telephone_number": "760-346-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72750 COUNTRY CLUB DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704083",
            "telephone_number": "760-346-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLC MIRAGE INN, L.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-02",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "MUNOZ",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "414-918-5443"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Mirage Inn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Bivins, NURSE PRACTITIONER
• Leland Paul Black, MD
• Lawrence Burnett Blackmon, D.D.S.
• Kenneth Blake, H.I.S.
• Burton Charles Blaurock, O.D.
• Beverly Belle Blessing, FNP, PHD
• Jonathan William Blevins, M.D.
• Block Counseling, Family & Child Therapy Inc.
• Blood & Cancer Genetics Institute
• Randy Bloom, FNP-BC

• Assisted Living Facility in Rancho Mirage, CA
• Providers in Rancho Mirage, 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 Aug 2, 2024; 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.