Overlake Terrace Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

603224991 Issued in WA

Legal business name

OVERLAKE TERRACE ASSISTED LIVING

Practice address

2825 E Cottonwood Pkwy
Suite 500
Salt Lake City, UT 84121-7055

Phone

(801) 790-4652

Fax

(801) 214-1970

NPI assigned

Nov 15, 2012

Organization subpart

Yes

Parent organization

STELLAR SENIOR LIVINGAs reported in NPPES

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

Authorized official

Name

Aaron C Benton

Title

Senior Vice President

Phone

(801) 790-4652

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1912241001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 E COTTONWOOD PKWY",
            "address_2": "SUITE 500",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841217055",
            "telephone_number": "801-790-4652",
            "fax_number": "801-214-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 E COTTONWOOD PKWY",
            "address_2": "SUITE 500",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841217055",
            "telephone_number": "801-790-4652",
            "fax_number": "801-214-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVERLAKE TERRACE ASSISTED LIVING",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STELLAR SENIOR LIVING",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "BENTON",
        "authorized_official_first_name": "AARON",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "801-790-4652"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WA",
            "license": "603224991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yarelly Lizbeth Ovalle Rodriguez
• Miguel Ovalle
• Kelly J Ovard
• Over the Road Dental
• Rebecca Overbury, M.D
• Jessica M Overson
• Amber Mecham Overton, PHARMD
• Melissa Oveson
• Samira Jay Oveson, D.D.S.
• Angela Mae Oviatt, MA

• Assisted Living Facility in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Assisted Living Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.