Nha@Grand Junction, LP

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

23R116 Issued in CO

Legal business name

NHA@GRAND JUNCTION, LP

Doing business as

Residence at Grand Mesa

Practice address

565 28 1/4 Rd
Grand Junction, CO 81501-4929

Phone

(970) 241-8899

NPI assigned

Nov 3, 2015

Organization subpart

No

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

Authorized official

Name

Robert Matrazzo, JD

Title

Coo

Phone

(305) 444-5007

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Residence at Grand Mesa Doing business as

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446508800000",
    "number": "1487027199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 28 1/4 RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815014929",
            "telephone_number": "970-241-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 28 1/4 RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815014929",
            "telephone_number": "970-241-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NHA@GRAND JUNCTION, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-03",
        "last_updated": "2015-11-03",
        "status": "A",
        "authorized_official_last_name": "MATRAZZO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "305-444-5007",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CO",
            "license": "23R116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "24058271",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Residence at Grand Mesa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Miranda Leigh Newman, MS, MFTC
• Keneka Rose Newton, PA-C
• Thomas Frederick Newton, MD
• Hoffman Quochuy Nguyen
• Vivian Thu Nguyen, PA-S
• Jennifer Lindsy Nichols I, LMT
• Victoria Nichols
• Dylan L Nicholson
• Sarah Nickell, BS
• Brittany Nickerson, BEHAVIOR ANALYST

• Assisted Living Facility in Grand Junction, CO
• Providers in Grand Junction, 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 Nov 3, 2015; 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.