Chancellor Health Care of California IV, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CHANCELLOR HEALTH CARE OF CALIFORNIA IV, INC.

Doing business as

The Woodlands Assisted Living

Practice address

1320 Windlass Dr
Baltimore, MD 21220-4100

Phone

(410) 918-2139

Fax

(410) 687-9909

NPI assigned

Dec 5, 2013

Last updated

Dec 5, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

CHANCELLOR HEALTH CARE, INC.As reported in NPPES

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

Authorized official

Name

Cluney Stagg

Title

Chief Financial Officer

Phone

(707) 687-1919

Specialties & licenses 1

Addresses

Other names 1

• The Woodlands Assisted Living Doing business as

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

{
    "created_epoch": "1386201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386201600000",
    "number": "1982035606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 JOHNSON ST",
            "city": "WINDSOR",
            "state": "CA",
            "postal_code": "954927435",
            "telephone_number": "707-687-1919",
            "fax_number": "707-687-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 WINDLASS DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212204100",
            "telephone_number": "410-918-2139",
            "fax_number": "410-687-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANCELLOR HEALTH CARE OF CALIFORNIA IV, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHANCELLOR HEALTH CARE, INC.",
        "enumeration_date": "2013-12-05",
        "last_updated": "2013-12-05",
        "status": "A",
        "authorized_official_last_name": "STAGG",
        "authorized_official_first_name": "CLUNEY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "707-687-1919"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Woodlands Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Neal Sood Chan, MD
• Theresa Y Chan, MD
• Wesley Chan
• Swati Chanani, MD
• Chance to Change Supportive Services of Maryland Inc
• Chintam Sai Chandan Reddy
• Cheruvari Sushil Chander, M.D.
• Rishi Chandiramani
• Elizabeth M Chandler, NP
• Paris Chandler

• Assisted Living Facility in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Assisted Living Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2013; 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.