NPIMap

Organization Active NPI

Summerville 2, LLC

  • Assisted Living Facility
  • La Porte, IN
National Provider Identifier
1790011765
Registry record updated Oct 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
07-010890-1 Issued in IN
Legal business name
SUMMERVILLE 2, LLC
Doing business as
Brentwood at LaPorte
Practice address
2002 Andrew Ave
La Porte, IN 46350-6545
Phone
(219) 325-1599
Fax
(219) 362-1682
NPI assigned
Oct 27, 2009
Organization subpart
Yes
Parent organization
SUMMERVILLE INVESTORS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 27, 2009

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 07-010890-1 IN Primary

Addresses

Primary practice location

2002 Andrew Ave
La Porte, IN 46350-6545

Mailing address

3131 Elliott Ave
Suite 500
Seattle, WA 98121-1044
Phone (206) 298-2909

Other names 1

  • Brentwood at LaPorte Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Summerville 13 LLC4 organizations share this tax ID, including this one
Part of
Summerville at St Augustine LLC

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256601600000",
    "number": "1790011765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 ELLIOTT AVE",
            "address_2": "SUITE 500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211044",
            "telephone_number": "206-298-2909",
            "fax_number": "206-301-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 ANDREW AVE",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463506545",
            "telephone_number": "219-325-1599",
            "fax_number": "219-362-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERVILLE 2, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMERVILLE INVESTORS, LLC",
        "enumeration_date": "2009-10-27",
        "last_updated": "2009-10-27",
        "status": "A",
        "authorized_official_last_name": "BICKEL",
        "authorized_official_first_name": "NOELLE",
        "authorized_official_middle_name": "DIAZ",
        "authorized_official_title_or_position": "LICENSING SPECIALIST",
        "authorized_official_telephone_number": "206-298-2909"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IN",
            "license": "07-010890-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brentwood at LaPorte",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Porte, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.