Narragansett Bay Holdings LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

NARRAGANSETT BAY HOLDINGS LLC

Practice address

2435 Wagner Heights Rd
Stockton, CA 95209-1778

Phone

(209) 477-5353

NPI assigned

Sep 18, 2024

Organization subpart

No

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

Authorized official

Name

Toby Tilford

Title

Co-Ceo

Phone

(858) 774-8342

Specialties & licenses 1

Addresses

Other names 1

• Crystal Creek Senior Living Doing business as

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1467289892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16544 FRANZEN FARM RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921272240",
            "telephone_number": "858-798-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 WAGNER HEIGHTS RD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952091778",
            "telephone_number": "209-477-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NARRAGANSETT BAY HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "TILFORD",
        "authorized_official_first_name": "TOBY",
        "authorized_official_title_or_position": "CO-CEO",
        "authorized_official_telephone_number": "858-774-8342"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crystal Creek Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sri Ratna Divya Nanduri
• Brad Nanigian, MD
• Vijaysri Nannapaneni
• Aasim Naqvi, MD
• Christina Naranjo
• Saiprasad Narsingam, M.D.
• Venus Basto Narvarte, ADMINISTRATOR
• Sahir Naseer, MD
• Uzair Naseer
• Brandon Luther Nash, DDS

• Assisted Living Facility in Stockton, CA
• Providers in Stockton, 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 Sep 18, 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.