Stonebrook Properties LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

STONEBROOK PROPERTIES LLC

Doing business as

Champlain Valley Senior Community

Practice address

10 Gilliland LN
Willsboro, NY 12996-3726

Phone

(518) 334-6868

NPI assigned

May 11, 2021

Last updated

May 11, 2021By 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

Eli Schwartzberg

Title

Owner/Operator

Phone

(518) 334-6868

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Champlain Valley Senior Community Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620691200000",
    "number": "1467036962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 GILLILAND LN",
            "city": "WILLSBORO",
            "state": "NY",
            "postal_code": "129963726",
            "telephone_number": "518-334-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 GILLILAND LN",
            "city": "WILLSBORO",
            "state": "NY",
            "postal_code": "129963726",
            "telephone_number": "518-334-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONEBROOK PROPERTIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A",
        "authorized_official_last_name": "SCHWARTZBERG",
        "authorized_official_first_name": "ELI",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "518-334-6868"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOH LICENSE NUMBER",
            "identifier": "260-F-018",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "CompuCare",
            "affiliation": "N",
            "address_1": "10 Gilliland Ln",
            "city": "Willsboro",
            "state": "NY",
            "country_code": "US",
            "postal_code": "129963726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Champlain Valley Senior Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Willsboro, NY
• Providers in Willsboro, NY by specialty
• Assisted Living Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.