Moraga Retreat Care Home Incorporated

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

075601205 Issued in CA

Legal business name

MORAGA RETREAT CARE HOME INCORPORATED

Practice address

715 Moraga Rd
Moraga, CA 94556-2341

Phone

(925) 376-2273

Fax

(925) 376-7137

NPI assigned

Jul 23, 2018

Organization subpart

No

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

Authorized official

Name

Roland Gabriel Blaj

Title

President

Phone

(925) 708-9877

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532304000000",
    "number": "1891272803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 MORAGA RD",
            "city": "MORAGA",
            "state": "CA",
            "postal_code": "945562341",
            "telephone_number": "925-376-2273",
            "fax_number": "925-376-7137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 MORAGA RD",
            "city": "MORAGA",
            "state": "CA",
            "postal_code": "945562341",
            "telephone_number": "925-376-2273",
            "fax_number": "925-376-7137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Woodford Dr",
            "address_purpose": "LOCATION",
            "city": "Moraga",
            "state": "CA",
            "postal_code": "945562418",
            "country_code": "US",
            "telephone_number": "925-376-2273",
            "fax_number": "925-376-7137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MORAGA RETREAT CARE HOME INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-23",
        "last_updated": "2018-07-23",
        "status": "A",
        "authorized_official_last_name": "BLAJ",
        "authorized_official_first_name": "ROLAND",
        "authorized_official_middle_name": "GABRIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-708-9877"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "075601205",
            "primary": true
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "075601509",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Moraga, CA
• Providers in Moraga, 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 Jul 23, 2018; 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.