Atlantis Lodi Opco LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ATLANTIS LODI OPCO LLC

Practice address

1321 S Fairmont Ave
Lodi, CA 95240-5520

Phone

(209) 334-3436

NPI assigned

Jan 12, 2022

Organization subpart

No

Name

Joshua Johnson

Title

Managing Member

Phone

(949) 291-7552

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 12, 2022.

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641945600000",
    "number": "1508517426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 S FAIRMONT AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 S FAIRMONT AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405520",
            "telephone_number": "209-334-3436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIS LODI OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-12",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "949-291-7552"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.