Idyllwood Manor at Andes CT., LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

23V725 Issued in CO

Legal business name

IDYLLWOOD MANOR AT ANDES CT., LLC

Practice address

5286 S Andes CT
Centennial, CO 80015-4896

Phone

(303) 513-4784

Fax

(303) 799-5837

NPI assigned

Apr 5, 2016

Organization subpart

No

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

Authorized official

Name

Bob Manzi

Title

Member

Phone

(303) 513-4784

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1417310509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2253",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801341414",
            "telephone_number": "303-513-4784",
            "fax_number": "303-799-5837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5286 S ANDES CT",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800154896",
            "telephone_number": "303-513-4784",
            "fax_number": "303-799-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDYLLWOOD MANOR AT ANDES CT., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-05",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "MANZI",
        "authorized_official_first_name": "BOB",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "303-513-4784"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CO",
            "license": "23V725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Apr 5, 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.