Provider Demographics
NPI:1407150287
Name:ATRIA SENIOR LIVING GROUP, INC
Entity Type:Organization
Organization Name:ATRIA SENIOR LIVING GROUP, INC
Other - Org Name:WOODBRIDGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-779-7608
Mailing Address - Street 1:1 WITHERSPOON
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-8637
Mailing Address - Country:US
Mailing Address - Phone:949-654-8500
Mailing Address - Fax:
Practice Address - Street 1:1 WITHERSPOON
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-8637
Practice Address - Country:US
Practice Address - Phone:949-654-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATRIA SENIOR LIVING GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility