Applegate Assisted Living Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

APPLEGATE ASSISTED LIVING INC.

Practice address

1541 E 4250 N
Buhl, ID 83316-5816

Phone

(208) 543-4020

NPI assigned

Mar 25, 2022

Last updated

Mar 25, 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

Brian Crabtree

Title

Owner

Phone

(208) 731-0862

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648166400000",
    "number": "1679223341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "BUHL",
            "state": "ID",
            "postal_code": "833160547",
            "telephone_number": "208-731-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 E 4250 N",
            "city": "BUHL",
            "state": "ID",
            "postal_code": "833165816",
            "telephone_number": "208-543-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLEGATE ASSISTED LIVING INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-25",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A",
        "authorized_official_last_name": "CRABTREE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-731-0862"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M8082574",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mail@applegateassistedliving.com",
            "affiliation": "N",
            "endpointDescription": "Applegate",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1541 E 4250 N",
            "city": "Buhl",
            "state": "ID",
            "country_code": "US",
            "postal_code": "833165816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.