Parkside Villa Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PARKSIDE VILLA ASSISTED LIVING LLC

Practice address

1502 N Rochester Dr
Gilbert, AZ 85234-1472

Phone

(480) 292-7387

NPI assigned

Aug 9, 2011

Last updated

Aug 9, 2011By 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

Florida Bomongcag

Title

Owner/Member

Phone

(480) 292-7387

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1922387901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 N ROCHESTER DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852341472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 N ROCHESTER DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852341472",
            "telephone_number": "480-292-7387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE VILLA ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-09",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "BOMONGCAG",
        "authorized_official_first_name": "FLORIDA",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "480-292-7387"
    },
    "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 Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.