Victorian Square, LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

ACL0000000147 Issued in TN

Legal business name

VICTORIAN SQUARE, LLC

Doing business as

Victorian Square Assisted Living Facility

Practice address

241 S Chamberlain Ave
Rockwood, TN 37854-6542

Phone

(865) 354-1133

Fax

(865) 354-6371

NPI assigned

Jun 6, 2007

Last updated

Jan 24, 2013By 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

Mr. Ralph H Bellande

Title

Managing Partner

Phone

(502) 228-8131

Specialties & licenses 1

Addresses

Other names 1

• Victorian Square Assisted Living Facility Doing business as

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358985600000",
    "number": "1710180955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12933 W HIGHWAY 42",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400599107",
            "telephone_number": "502-228-8131",
            "fax_number": "502-228-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 S CHAMBERLAIN AVE",
            "city": "ROCKWOOD",
            "state": "TN",
            "postal_code": "378546542",
            "telephone_number": "865-354-1133",
            "fax_number": "865-354-6371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIAN SQUARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2013-01-24",
        "status": "A",
        "authorized_official_last_name": "BELLANDE",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "502-228-8131",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "TN",
            "license": "ACL0000000147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victorian Square Assisted Living Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility (Mental Illness) in Rockwood, TN
• Providers in Rockwood, TN by specialty
• Assisted Living Facility (Mental Illness) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.