Berryman Health, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

010000014 Issued in CA

Legal business name

BERRYMAN HEALTH, INC

Doing business as

Healdsburg Senior Living Community

Practice address

725 Grove St
Healdsburg, CA 95448-4756

Phone

(707) 433-4877

Fax

(707) 433-5974

NPI assigned

Dec 13, 2006

Last updated

Dec 14, 2007By 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

Ms. Faye Linclon

Title

V.P. Policy and Government Relation

Phone

(801) 325-0153

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Healdsburg Senior Living Community Doing business as

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197590400000",
    "number": "1699837229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 E 400 S",
            "address_2": "SUITE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841112846",
            "telephone_number": "801-325-0153",
            "fax_number": "801-596-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 GROVE ST",
            "city": "HEALDSBURG",
            "state": "CA",
            "postal_code": "954484756",
            "telephone_number": "707-433-4877",
            "fax_number": "707-433-5974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERRYMAN HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-12-14",
        "status": "A",
        "authorized_official_last_name": "LINCLON",
        "authorized_official_first_name": "FAYE",
        "authorized_official_title_or_position": "V.P. POLICY AND GOVERNMENT RELATION",
        "authorized_official_telephone_number": "801-325-0153",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "010000014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55820F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healdsburg Senior Living Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Healdsburg, CA
• Providers in Healdsburg, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; 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.