NPIMap

Organization Active NPI

Summerville at Cobbco, Inc.

  • Assisted Living Facility
  • Fairfield, CA
National Provider Identifier
1780913582
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
486800641 Issued in CA
Legal business name
SUMMERVILLE AT COBBCO, INC.
Practice address
1095 E Tabor Ave
Fairfield, CA 94533-4190
Phone
(707) 422-1565
NPI assigned
Dec 8, 2009
Organization subpart
Yes
Parent organization
SUMMERVILLE SENIOR LIVING, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

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

Authorized official

Name
Noelle Bickel
Title
Licensing Specialist
Phone
(206) 298-2909

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 486800641 CA Primary
Alzheimer Center (Dementia Center) 311500000X 486800641 CA

Addresses

Primary practice location

1095 E Tabor Ave
Fairfield, CA 94533-4190

Mailing address

3131 Elliott Ave Ste 500
Seattle, WA 98121-1032

Other names 1

  • Emeritus at Westwind Gardens Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Summerville at Cobbco Inc18 organizations share this tax ID, including this one
Part of
Summerville at St Augustine LLC

Other organizations with this tax ID 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260230400000",
    "number": "1780913582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 ELLIOTT AVE STE 500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 E TABOR AVE",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945334190",
            "telephone_number": "707-422-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERVILLE AT COBBCO, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMERVILLE SENIOR LIVING, INC.",
        "enumeration_date": "2009-12-08",
        "last_updated": "2009-12-08",
        "status": "A",
        "authorized_official_last_name": "BICKEL",
        "authorized_official_first_name": "NOELLE",
        "authorized_official_title_or_position": "LICENSING SPECIALIST",
        "authorized_official_telephone_number": "206-298-2909"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "486800641",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "CA",
            "license": "486800641",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emeritus at Westwind Gardens",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; 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.