Andromeda Escape

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

ANDROMEDA ESCAPE

Doing business as

Sapphire Pacific

Practice address

17207 Buttonwood St
Fountain Valley, CA 92708-3508

Phone

(619) 919-4919

Fax

(866) 602-7153

NPI assigned

Nov 11, 2024

Last updated

Nov 11, 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

Ali Naghibi

Title

Ceo

Phone

(714) 322-1910

Specialties & licenses 1

Addresses

Other names 1

• Sapphire Pacific Doing business as

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1467276121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17207 BUTTONWOOD ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083508",
            "telephone_number": "619-919-4919",
            "fax_number": "866-602-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17207 BUTTONWOOD ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083508",
            "telephone_number": "619-919-4919",
            "fax_number": "866-602-7153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDROMEDA ESCAPE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-10",
        "status": "A",
        "authorized_official_last_name": "NAGHIBI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-322-1910"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sapphire Pacific",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Care Home Facility in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Adult Care Home Facility in California

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