Eden Vista Joliet LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EDEN VISTA JOLIET LLC

Practice address

3315 Executive Dr
Joliet, IL 60431-8500

Phone

(773) 825-3336

NPI assigned

Aug 21, 2024

Last updated

Aug 21, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Max Stesel

Title

Manager

Phone

(773) 825-3336

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1724198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1417780933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 MCCORMICK BLVD STE 112",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762914",
            "telephone_number": "773-825-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 EXECUTIVE DR",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604318500",
            "telephone_number": "773-825-3336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3320 Executive Dr",
            "address_purpose": "LOCATION",
            "city": "Joliet",
            "state": "IL",
            "postal_code": "604318433",
            "country_code": "US",
            "telephone_number": "773-825-3336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EDEN VISTA JOLIET LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-21",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "STESEL",
        "authorized_official_first_name": "MAX",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-825-3336",
        "authorized_official_name_prefix": "Mr."
    },
    "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 Joliet, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.