Basic Information
| Provider Information | |||||||||
| NPI: | 1265765556 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALGT,LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 28202 CABOT RD | ||||||||
| Address2: | 412 | ||||||||
| City: | LAGUNA NIGUEL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926771222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9493477100 | ||||||||
| FaxNumber: | 9493477800 | ||||||||
| Practice Location | |||||||||
| Address1: | 14966 TERRENO DE FLORES LN | ||||||||
| Address2: | |||||||||
| City: | LOS GATOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950322023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9493477100 | ||||||||
| FaxNumber: | 9493477800 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2009 | ||||||||
| LastUpdateDate: | 05/04/2012 | ||||||||
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| AuthorizedOfficialLastName: | BRADSHAW | ||||||||
| AuthorizedOfficialFirstName: | JEFFREY | ||||||||
| AuthorizedOfficialMiddleName: | JARED | ||||||||
| AuthorizedOfficialTitleorPosition: | SECRETARY/VP OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 7145488046 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.