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

Last updated

Jan 12, 2022By 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

Joshua Johnson

Title

Managing Member

Phone

(949) 291-7552

Specialties & licenses 1

Addresses

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

{
    "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.