Special Request LLC

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

Legal business name

SPECIAL REQUEST LLC

Doing business as

Eden Assisted Living

Practice address

18787 Carlton Ave
Castro Valley, CA 94546-2905

Phone

(510) 292-8610

NPI assigned

Nov 14, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Samuel Alin Tet

Title

LLC Member

Phone

(510) 292-8610

Specialties & licenses 1

Addresses

Other names 1

• Eden Assisted Living Doing business as

Tax ID family

Eden Assisted Living2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Special Request LLC

  • Custodial Care Facility
  • Castro Valley, CA
  • NPI 1740826163
  NPD tax ID

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573689600000",
    "number": "1740825611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18821 CARLTON AVE",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945462907",
            "telephone_number": "415-797-9266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18787 CARLTON AVE",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945462905",
            "telephone_number": "510-292-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIAL REQUEST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-11-14",
        "status": "A",
        "authorized_official_last_name": "TET",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "ALIN",
        "authorized_official_title_or_position": "LLC MEMBER",
        "authorized_official_telephone_number": "510-292-8610",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eden Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ameya Solanki
• Jeffrey Lee Somersett, LCSW
• Da Song
• Nayoung Song, RD
• Kristina Marie Sotto, OTR/L
• Special Request LLC
• Nydia J Spencer
• Farin Spradling
• Shobha Srinivasan
• Barett St Germain

• Custodial Care Facility in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Custodial Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; 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.