NPIMap

Organization Active NPI

Arv Assisted Living, Inc.

Doing business as Willow Glen

  • Assisted Living Facility
  • San Jose, CA
National Provider Identifier
1841594777
Registry record updated Jan 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
ARV ASSISTED LIVING, INC.
Doing business as
Willow Glen
Practice address
1660 Gaton Dr
San Jose, CA 95125-4534
Phone
(408) 266-1660
NPI assigned
Jan 7, 2011
Last updated
Jan 7, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
ARV ASSISTED LIVING, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2011

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

Authorized official

Name
John Moore
Title
Ceo
Phone
(502) 779-7608

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU Primary

Addresses

Primary practice location

1660 Gaton Dr
San Jose, CA 95125-4534

Mailing address

1660 Gaton Dr
San Jose, CA 95125-4534
Phone (408) 266-1660

Other names 1

  • Willow Glen Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2222414WG Willow Glen SH, LP1660 Gaton Drive, San Jose, CA 95125Certificate of waiverApr 27, 2027

National Provider Directory

National Provider Directory
Tax ID family
Arv Assisted Living Inc30 organizations share this tax ID, including this one
Part of
Arv Assisted Living Inc

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1294358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294358400000",
    "number": "1841594777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 GATON DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951254534",
            "telephone_number": "408-266-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 GATON DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951254534",
            "telephone_number": "408-266-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARV ASSISTED LIVING, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARV ASSISTED LIVING, INC.",
        "enumeration_date": "2011-01-07",
        "last_updated": "2011-01-07",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "502-779-7608"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willow Glen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.