Clubhouse Senior Estate LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CLUBHOUSE SENIOR ESTATE LLC

Practice address

1324 S Fann St
Anaheim, CA 92804-5648

Phone

(909) 900-6064

NPI assigned

Apr 27, 2026

Last updated

Apr 27, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gary Tadeo

Title

Ceo

Phone

(909) 900-6064

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1777248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1871439281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 S FANN ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928045648",
            "telephone_number": "909-900-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 S FANN ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928045648",
            "telephone_number": "909-900-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLUBHOUSE SENIOR ESTATE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-27",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "TADEO",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-900-6064"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Anaheim, CA
• Providers in Anaheim, 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 27, 2026; 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.