7125 Main, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

7125 MAIN, LLC

Doing business as

PLC 7125 Main

Practice address

7125 Main Ave
Orangevale, CA 95662-2813

Phone

(916) 987-7285

Fax

(415) 358-8554

NPI assigned

May 9, 2024

Last updated

Dec 13, 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. Robert J Coleman

Title

Liscensee

Phone

(707) 430-1608

Specialties & licenses 1

Addresses

Other names 1

• PLC 7125 Main Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mickey Iliescu

  • Custodial Care Facility
  • Orangevale, CA
  • NPI 1386176808
  NPD (past)

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

{
    "created_epoch": "1715212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1427806090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7125 MAIN AVE",
            "city": "ORANGEVALE",
            "state": "CA",
            "postal_code": "956622813",
            "telephone_number": "916-987-7285",
            "fax_number": "415-358-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7125 MAIN AVE",
            "city": "ORANGEVALE",
            "state": "CA",
            "postal_code": "956622813",
            "telephone_number": "916-987-7285",
            "fax_number": "415-358-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "7125 MAIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-09",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "LISCENSEE",
        "authorized_official_telephone_number": "707-430-1608",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PLC 7125 Main",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Acquired Healthcare LLC
• Advanced Practice Primary Care a Registered Nursing Corporation

• Assisted Living Facility in Orangevale, CA
• Providers in Orangevale, 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 Dec 13, 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.