Summerville at Heritage Place, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

397003261 Issued in CA

Legal business name

SUMMERVILLE AT HERITAGE PLACE, LLC

Doing business as

Emeritus at Heritage Place

Practice address

355 W Grant Line Rd
Tracy, CA 95376-2500

Phone

(209) 835-1000

NPI assigned

Jun 5, 2007

Last updated

Sep 10, 2009By 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

Noelle Diaz

Title

Licensing Specialist

Phone

(206) 301-4060

Specialties & licenses 2

Addresses

Other names 1

• Emeritus at Heritage Place Doing business as

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252540800000",
    "number": "1659573004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 EXECUTIVE PKWY",
            "address_2": "SUITE 530",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945834255",
            "telephone_number": "925-866-1999",
            "fax_number": "925-866-8468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 W GRANT LINE RD",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953762500",
            "telephone_number": "209-835-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERVILLE AT HERITAGE PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2009-09-10",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "NOELLE",
        "authorized_official_title_or_position": "LICENSING  SPECIALIST",
        "authorized_official_telephone_number": "206-301-4060"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "397003261",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "CA",
            "license": "397003261",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emeritus at Heritage Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Tracy, CA
• Providers in Tracy, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.

Verify at the official NPI Registry.