Active NPI
Summerville at Cobbco, Inc.
- Assisted Living Facility
- Orange, CA
National Provider Identifier
1609105394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- 306001002
- Legal business name
- SUMMERVILLE AT COBBCO, INC.
- Practice address
- 142 S Prospect St
Orange, CA 92869-3842 - Phone
- (714) 639-3590
- Fax
- (714) 639-0833
- NPI assigned
- Dec 9, 2009
- Organization subpart
- Yes
- Parent organization
- SUMMERVILLE SENIOR LIVING, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Noelle Diaz Bickel
- Title
- Licensing Specialist
- Phone
- (206) 298-9090
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 306001002 | CA | Primary |
Addresses
Primary practice location
142 S Prospect St
Orange, CA 92869-3842
Mailing address
3131 Elliott Ave
Suite 500
Seattle, WA 98121-1044
Phone (206) 298-2909
Other names 1
- Emeritus at Orange
National Provider Directory
National Provider Directory- Tax ID family
- Summerville at Cobbco Inc
- Part of
- Summerville at St Augustine LLC
Other organizations with this tax ID 17
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Locations
142 S Prospect St
Orange, CA 92869
Phone (714) 639-3590
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260316800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1260316800000",
"number": "1609105394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3131 ELLIOTT AVE",
"address_2": "SUITE 500",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981211044",
"telephone_number": "206-298-2909",
"fax_number": "206-301-4500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "142 S PROSPECT ST",
"city": "ORANGE",
"state": "CA",
"postal_code": "928693842",
"telephone_number": "714-639-3590",
"fax_number": "714-639-0833"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUMMERVILLE AT COBBCO, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SUMMERVILLE SENIOR LIVING, INC.",
"enumeration_date": "2009-12-09",
"last_updated": "2009-12-09",
"status": "A",
"authorized_official_last_name": "BICKEL",
"authorized_official_first_name": "NOELLE",
"authorized_official_middle_name": "DIAZ",
"authorized_official_title_or_position": "LICENSING SPECIALIST",
"authorized_official_telephone_number": "206-298-9090"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "CA",
"license": "306001002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Emeritus at Orange",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.