Lake Havasu Too, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ALC 4959 Issued in AZ

Legal business name

LAKE HAVASU TOO, LLC

Doing business as

Prestige Assisted Living at Claremont

Practice address

1221 Claremont Dr
Lake Havasu City, AZ 86406-8684

Phone

(928) 855-4843

Fax

(928) 855-2987

NPI assigned

Feb 28, 2007

Last updated

Aug 22, 2020By 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. Gregory J Vislocky

Title

Managing Member

Phone

(360) 735-7155

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Prestige Assisted Living at Claremont Doing business as

Tax ID family

Lake Havasu Too LLC2 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.

• Prestige Assisted Living at Claremont

  • Assisted Living Facility
  • Lake Havasu City, AZ
  • NPI 1780719039
  NPD tax ID

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790812436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 NE PARKWAY DR",
            "address_2": "SUITE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626648",
            "telephone_number": "360-735-7155",
            "fax_number": "360-735-9416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 CLAREMONT DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864068684",
            "telephone_number": "928-855-4843",
            "fax_number": "928-855-2987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE HAVASU TOO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VISLOCKY",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "360-735-7155",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "ALC 4959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21159",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Assisted Living at Claremont",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Lake Havasu Unified School Distrct
• Lake Havasu Unified School District #1
• Lake View Terrace Management LLC
• Lake View Terrace Memory Care (LHC Partners LP)
• Lakeside Heart and Vascular Center PLLC

• Assisted Living Facility in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.