Asta Care Center of Rockford LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0041772 Issued in IL

Legal business name

ASTA CARE CENTER OF ROCKFORD LLC

Practice address

707 W Riverside Blvd
Rockford, IL 61103-2125

Phone

(815) 877-5752

Fax

(815) 282-2203

NPI assigned

Nov 9, 2005

Organization subpart

No

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

Authorized official

Name

Seth Gillman

Title

Member

Phone

(815) 877-5752

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1821079591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 W RIVERSIDE BLVD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611032125",
            "telephone_number": "815-877-5752",
            "fax_number": "815-282-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 W RIVERSIDE BLVD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611032125",
            "telephone_number": "815-877-5752",
            "fax_number": "815-282-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASTA CARE CENTER OF ROCKFORD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "GILLMAN",
        "authorized_official_first_name": "SETH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "815-877-5752"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0041772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.