Davidson Brookdale LLC.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

DAVIDSON BROOKDALE LLC.

Practice address

1326 Brookdale Dr
Merced, CA 95340-1639

Phone

(916) 225-0349

NPI assigned

Mar 13, 2021

Organization subpart

No

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

Authorized official

Name

Godwin Aka

Title

Administrator/ Ceo

Phone

(916) 225-0349

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1615593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615593600000",
    "number": "1831774603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8194 SUNRISE BLVD",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956101535",
            "telephone_number": "916-727-9127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1326 BROOKDALE DR",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953401639",
            "telephone_number": "916-225-0349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIDSON BROOKDALE LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-13",
        "last_updated": "2021-03-13",
        "certification_date": "2021-03-13",
        "status": "A",
        "authorized_official_last_name": "AKA",
        "authorized_official_first_name": "GODWIN",
        "authorized_official_title_or_position": "ADMINISTRATOR/ CEO",
        "authorized_official_telephone_number": "916-225-0349"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ife@citruscg.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Citrus Care Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1326 Brookdale Dr",
            "city": "Merced",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953401639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Intellectual Disabilities Intermediate Care Facility in Merced, CA
• Providers in Merced, CA by specialty
• Intellectual Disabilities Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2021; 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.