NPIMap

Organization Active NPI

Extended Care Portfolio Multistate Pool Tenant, LLC

  • Alzheimer Center (Dementia Center)
  • Tucson, AZ
National Provider Identifier
1760814727
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Alzheimer Center (Dementia Center)Taxonomy code 311500000X
License
AL6987C Issued in AZ
Legal business name
EXTENDED CARE PORTFOLIO MULTISTATE POOL TENANT, LLC
Practice address
2675 N Wyatt Dr
Tucson, AZ 85712-6107
Phone
(520) 320-7505
NPI assigned
Aug 1, 2013
Organization subpart
Yes
Parent organization
EXTENDED CARE PORTFOLIO TENANT, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Authorized official

Name
Mr. Bruce Schoen
Title
Ex VP/Cfo
Phone
(503) 905-3347

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Alzheimer Center (Dementia Center) 311500000X AL6987C AZ Primary

Addresses

Primary practice location

2675 N Wyatt Dr
Tucson, AZ 85712-6107

Mailing address

1785 Hancock St
Suite 100
San Diego, CA 92110-2073
Phone (619) 296-9000

National Provider Directory

National Provider Directory
Tax ID family
Extended Care Portfolio Tenant LLC11 organizations share this tax ID, including this one
Part of
Extended Care Portfolio Tenant LLC

Other organizations with this tax ID 10

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

Locations

1785 Hancock St
Ste 100
San Diego, CA 92110

NPI Registry JSON

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375315200000",
    "number": "1760814727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1785 HANCOCK ST",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102073",
            "telephone_number": "619-296-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 N WYATT DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857126107",
            "telephone_number": "520-320-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED CARE PORTFOLIO MULTISTATE POOL TENANT, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXTENDED CARE PORTFOLIO TENANT, LLC",
        "enumeration_date": "2013-08-01",
        "last_updated": "2013-08-01",
        "status": "A",
        "authorized_official_last_name": "SCHOEN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "EX VP/CFO",
        "authorized_official_telephone_number": "503-905-3347",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "AZ",
            "license": "AL6987C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.