S-H Opco Peridot, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

S-H OPCO PERIDOT, LLC

Doing business as

The Peridot

Practice address

211 Bradshaw Dr
Prescott, AZ 86303-4405

Phone

(928) 777-5511

NPI assigned

Aug 1, 2014

Organization subpart

No

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

Authorized official

Name

Mark Ohlendorf

Title

Cfo

Phone

(414) 918-5000

Specialties & licenses 1

Addresses

Other names 1

• The Peridot Doing business as

Locations

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

{
    "created_epoch": "1406851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406851200000",
    "number": "1467860593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6737 W WASHINGTON ST",
            "address_2": "SUITE 2300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532145647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 BRADSHAW DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863034405",
            "telephone_number": "928-777-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S-H OPCO PERIDOT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-01",
        "last_updated": "2014-08-01",
        "status": "A",
        "authorized_official_last_name": "OHLENDORF",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "414-918-5000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Peridot",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Haley Ruth, OTR/L
• Vincent Joseph Ruzzo Jr., PHD
• Ryan S. Brown, DDS PLLC
• Dale Ryder, LCSW
• Cheryl A Rynd, LMT, MMP
• Kathi Sabot, RN
• Andrew Robert Sacks, D.O.
• Stanford Paul Sadick, D.O.
• Sam Safavi-Abbasi, MD
• Safeway Inc

• Assisted Living Facility in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; 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.