The Pavilion at Vestal, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

TO BE DETERMINED Issued in NY

Legal business name

THE PAVILION AT VESTAL, LLC

Practice address

105 West Sheedy Road
Vestal, NY 13850-1753

Phone

(845) 371-8100

Fax

(845) 371-0010

NPI assigned

May 14, 2015

Last updated

May 14, 2015By 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. Jack Augenstein

Title

Cfo

Phone

(845) 371-8100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1790163376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HILLCREST CTR",
            "address_2": "SUITE #325",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109773740",
            "telephone_number": "845-371-8100",
            "fax_number": "845-371-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WEST SHEEDY ROAD",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501753",
            "telephone_number": "845-371-8100",
            "fax_number": "845-371-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PAVILION AT VESTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "AUGENSTEIN",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "845-371-8100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NY",
            "license": "TO BE DETERMINED",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Vestal, NY
• Providers in Vestal, NY by specialty
• Assisted Living Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; 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.