ELITE ASSISTED LIVING HOME (NPI# 1356885164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356885164 |
| Entity Type | Organization |
| Organization Name | ELITE ASSISTED LIVING HOME |
| Practice Address |
15928 W Ironwood Dr Waddell AZ 85355-2001 |
| Mailing Address |
9559 W Pinnacle Vista Dr Peoria AZ 85383-8715 |
| Practice Telephone | 6027439924 |
| Mailing Telephone | 6027439924 |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2016-12-13 |
| Authorized Official Name | ANGELA WOODWORTH (OWNER) |
| Authorized Official Telephone | 6027439924 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL8356H | AZ | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 498514 | 05 |
| Street Address |
15928 W IRONWOOD DR |
| City | WADDELL |
| State | AZ |
| Zip Code | 85355-2001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295135432 | Jennifer Fowler | Psychologist | 6431 N 181st Ave, Waddell, AZ 85355 | 2014-08-25 |
| 1033272646 | Norma M Hernandez | Technician | 18220 West North Court, Waddell, AZ 85355 | 2006-12-18 |
| 1326377565 | Amber Marie Werner | Military Health Care Provider | 9603 N 179th Dr, Waddell, AZ 85355-4107 | 2009-12-17 |
| 1306259171 | Aaron Alvarez | Military Health Care Provider | 18026 W Carol Ave, Waddell, AZ 85355-4127 | 2014-06-09 |
| 1528607108 | Amie Raina Cooke | Nurse Practitioner | 18072 W Vogel Ave, Waddell, AZ 85355-4133 | 2019-12-31 |
| 1245878982 | Ndolia Noma Carew Schild | Counselor | 17949 W Purdue Ave, Waddell, AZ 85355-4143 | 2019-12-12 |
| 1235307455 | Corrie Castelluccio | Specialist/Technologist | 17958 W Brown St, Waddell, AZ 85355-4151 | 2008-02-11 |
| 1578020285 | Shea Grant | Specialist/Technologist | 17958 W Brown St, Waddell, AZ 85355-4151 | 2019-02-28 |
| 1073015061 | Sarah Patricia Pratt | Specialist/Technologist | 17958 W Brown St, Waddell, AZ 85355-4151 | 2018-03-06 |
| 1417358870 | Brianna Dazzo | Specialist/Technologist | 17958 W Brown St, Waddell, AZ 85355-4151 | 2014-09-04 |
| Find all providers in zip 85355 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730508 | Gheorghe Patrutescu | Assisted Living Facility | 16134 N 72nd Ln, Peoria, AZ 85382-4937 | 2020-11-03 |
| 1942800966 | Yibu Liu | Assisted Living Facility | 3569 E Utopia Rd, Phoenix, AZ 85050-3967 | 2020-10-28 |
| 1386243269 | Harmony House Tucson LLC | Assisted Living Facility | 12651 E Speedway Blvd, Tucson, AZ 85748-2060 | 2020-10-21 |
| 1710586664 | Sunland Springs Memory Care, LLC | Assisted Living Facility | 2415 S Signal Butte Rd, Mesa, AZ 85209-2107 | 2020-10-21 |
| 1487253860 | Ronald Jingco Calaguas | Assisted Living Facility | 2432 W Portobello Ave, Mesa, AZ 85202-7871 | 2020-10-18 |
| 1992303374 | Azi House LLC | Assisted Living Facility | 1200 W Chapala Dr, Tucson, AZ 85704-4521 | 2020-10-16 |
| 1609474030 | Fisher Family Home LLC | Assisted Living Facility | 2927 W Redfield Rd, Phoenix, AZ 85053-7712 | 2020-10-16 |
| 1235736687 | Ana's Assisted Living Home, LLC | Assisted Living Facility | 13238 N 35th St, Phoenix, AZ 85032-6110 | 2020-10-07 |
| 1205433844 | Angelic Care LLC | Assisted Living Facility | 15247 W Wethersfield Rd, Surprise, AZ 85379-9177 | 2020-10-07 |
| 1689281347 | Gilbert Al Partners, Lp | Assisted Living Facility | 1445 E Willis Rd, Gilbert, AZ 85297-7352 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.