Autumn Ridge, L.P.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

107206271 Issued in CA

Legal business name

AUTUMN RIDGE, L.P.

Practice address

14280 W Stanislaus Ave
Kerman, CA 93630-1594

Phone

(559) 304-7095

NPI assigned

Apr 12, 2016

Last updated

Apr 12, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

TRINITY RETIREMENT SERVICES, INC.As reported in NPPES

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

Authorized official

Name

Mr. Barry William Byers, M.P.A.

Title

Licensee

Phone

(559) 304-7095

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Autumn Ridge Assisted Living2 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.

• Autumn Ridge, L.P.

  dba Autumn Ridge Assisted Living

  • Alzheimer Center (Dementia Center)
  • Kerman, CA
  • NPI 1023400389
  NPD tax ID

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460419200000",
    "number": "1831553114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2008 N THOMPSON AVE",
            "city": "REEDLEY",
            "state": "CA",
            "postal_code": "936548828",
            "telephone_number": "559-304-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14280 W STANISLAUS AVE",
            "city": "KERMAN",
            "state": "CA",
            "postal_code": "936301594",
            "telephone_number": "559-304-7095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTUMN RIDGE, L.P.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRINITY RETIREMENT SERVICES, INC.",
        "enumeration_date": "2016-04-12",
        "last_updated": "2016-04-12",
        "status": "A",
        "authorized_official_last_name": "BYERS",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "LICENSEE",
        "authorized_official_telephone_number": "559-304-7095",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.P.A."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "107206271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA DEP'T. OF SOCIAL SERVICES - COMMUNITY CARE LICENSING",
            "identifier": "107206271",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica Sandra Araya, MD
• Narissa Erin Arredondo, BSN, RN
• Jacqueline Arreola
• Autumn Ridge, L.P. (Autumn Ridge Assisted Living)
• Autumn Ridge, L.P.
• Mariah Haley Ayala
• Ramia Bell
• Leslie R Buhr, M.D.
• Jennifer Kimberly Caballero
• Brenda Jamelette Castellanos, B.A., M.A., PPS

• Assisted Living Facility in Kerman, CA
• Providers in Kerman, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; 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.