NPIMap

Organization Active NPI

Extended Care Portfolio Multistate Pool Tenant, LLC

Doing business as Pacifica Senior Living Millcreek

  • Assisted Living Facility
  • Salt Lake City, UT
National Provider Identifier
1801295894
Registry record updated Aug 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
UT207219 Issued in UT
Legal business name
EXTENDED CARE PORTFOLIO MULTISTATE POOL TENANT, LLC
Doing business as
Pacifica Senior Living Millcreek
Practice address
777 E 3900 S
Salt Lake City, UT 84107-2199
Phone
(801) 288-0700
Fax
(801) 288-2777
NPI assigned
Aug 15, 2014
Last updated
Aug 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2014

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

Authorized official

Name
Mr. Deepak Israni
Title
Manager
Phone
(619) 296-9000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X UT000249 UT
Assisted Living Facility 310400000X UT207219 UT Primary

Addresses

Primary practice location

777 E 3900 S
Salt Lake City, UT 84107-2199

Mailing address

1775 Hancock St Ste 200
San Diego, CA 92110-2036
Phone (619) 296-9000

Other names 1

  • Pacifica Senior Living Millcreek Doing business as

National Provider Directory

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

Other organizations with this tax ID 10

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": "1408060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408060800000",
    "number": "1801295894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 HANCOCK ST STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102036",
            "telephone_number": "619-296-9000",
            "fax_number": "619-296-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E 3900 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072199",
            "telephone_number": "801-288-0700",
            "fax_number": "801-288-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED CARE PORTFOLIO MULTISTATE POOL TENANT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-15",
        "last_updated": "2014-08-15",
        "status": "A",
        "authorized_official_last_name": "ISRANI",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "619-296-9000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "UT",
            "license": "UT000249",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "UT",
            "license": "UT207219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacifica Senior Living Millcreek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2014; 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.