NPIMap

Organization Active NPI

Assisted Living Concepts Inc

Doing business as Laurel Park Assisted Living

  • Assisted Living Facility
  • Port Angeles, WA
National Provider Identifier
1699891135
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
BH1840 Issued in WA
Legal business name
ASSISTED LIVING CONCEPTS INC
Doing business as
Laurel Park Assisted Living
Practice address
1133 East Park Avenue
Port Angeles, WA 98362
Phone
(360) 452-7201
Fax
(360) 452-4051
NPI assigned
Mar 22, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Walter A Levonowich
Title
Vice President and Controller
Phone
(414) 908-8800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X BH1840 WA Primary

Addresses

Primary practice location

1133 East Park Avenue
Port Angeles, WA 98362

Mailing address

111 W Michigan Street
9TH Floor
Milwaukee, WI 53203
Phone (414) 908-8800

Other identifiers 1

IdentifierTypeStateIssuer
749622MedicaidWA

Other names 1

  • Laurel Park Assisted Living Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Assisted Living Concepts Inc213 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699891135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W MICHIGAN STREET",
            "address_2": "9TH FLOOR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53203",
            "telephone_number": "414-908-8800",
            "fax_number": "414-908-8212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 EAST PARK AVENUE",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "98362",
            "telephone_number": "360-452-7201",
            "fax_number": "360-452-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSISTED LIVING CONCEPTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEVONOWICH",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT AND CONTROLLER",
        "authorized_official_telephone_number": "414-908-8800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WA",
            "license": "BH1840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "749622",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laurel Park Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Angeles, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.