Westside Assisted Living, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

WESTSIDE ASSISTED LIVING, INC.

Practice address

816 W Kiowa St
Colorado Springs, CO 80905-1423

Phone

(719) 578-1355

Fax

(719) 578-5889

NPI assigned

Dec 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Lynn Paul Boese

Title

Owner

Phone

(719) 578-1355

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457414336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2916 LA ESTRELLA CIR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809173313",
            "telephone_number": "719-591-1629",
            "fax_number": "719-574-7917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 W KIOWA ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809051423",
            "telephone_number": "719-578-1355",
            "fax_number": "719-578-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE ASSISTED LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOESE",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-578-1355",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04142410",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Colorado Springs, CO
• Providers in Colorado Springs, 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 Aug 22, 2020; 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.