LDRKAIR (NPI# 1386971877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386971877 |
| Entity Type | Organization |
| Organization Name | LDRKAIR |
| Other Organization Name | THE CARRIAGE HOUSE ON WEST GARDEN LANE |
| Practice Address |
395 W Garden Ln Snowflake AZ 85937-6218 |
| Practice Telephone | 9285367935 |
| Practice Fax Number | 9285365444 |
| Mailing Telephone | 9285367935 |
| Mailing Fax Number | 9285365444 |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2009-11-04 |
| Authorized Official Name | MR. LARRY DOUGLAS MATYAS (OWNER) |
| Authorized Official Telephone | 9285367935 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
ALC-4533 | AZ | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | EVERCARE PROVIDER SUBSCRIBER ID | EVC6003704 | 01 |
| AZ | EVERCARE PROVIDER CAREONE ID | 28275659 | 01 |
| Other Name | Type Code |
|---|---|
| The Carriage House on West Garden Lane | Doing Business As Name - Organization |
| Street Address |
395 W GARDEN LN |
| City | SNOWFLAKE |
| State | AZ |
| Zip Code | 85937-6218 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275990368 | Traumacare Institute, Pllc | Counselor | 61 West Center Street, Snowflake, AZ 85937 | 2016-01-21 |
| 1659736338 | Michael Shane Luck | Counselor | 61 West Center, Snowflake, AZ 85937 | 2015-12-22 |
| 1093128589 | Mark Porter Caldwell | Physical Therapist | 1788 Prairie Rd, Snowflake, AZ 85937 | 2014-06-03 |
| 1528329331 | Craig Reed West Dds PC | Dentist | 439 South Main, Snowflake, AZ 85937 | 2012-06-07 |
| 1295972651 | C and K Home Furnishings | Durable Medical Equipment & Medical Supplies | 1355 S. Main Street, Snowflake, AZ 85937 | 2009-01-07 |
| 1821274408 | Jackie C Blair | Counselor | 146 School Bus Lane, Snowflake, AZ 85937 | 2008-01-14 |
| 1164575650 | Snowflake Unified School District #5 | Local Education Agency (LEA) | 682 School Bus Lane, Snowflake, AZ 85937 | 2007-01-19 |
| 1225009608 | Larry W Nichols | Family Medicine | 590 S Main St, Snowflake, AZ 85937 | 2006-02-01 |
| 1326123720 | Snowflake School District | Local Education Agency (LEA) | 682 School Bus Lane, Snowflake School District, Snowflake, AZ 85937-0000 | 2006-10-25 |
| 1679710529 | White Mountain Eye Care Center PC | Optometrist | 176 N Main St, Snowflake, AZ 85937-5054 | 2009-01-14 |
| Find all providers in zip 85937 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093783 | Rossana R. Barretto | Custodial Care Facility | 16948 W Magnolia St, Goodyear, AZ 85338-7428 | 2020-11-06 |
| 1467051508 | Lifes Journey LLC | Custodial Care Facility | 7591 N 85th Dr, Glendale, AZ 85305-3982 | 2020-10-20 |
| 1134736820 | Bernadette Tolentino Reyes | Custodial Care Facility | 2406 S Pecan Dr, Chandler, AZ 85286-7406 | 2020-09-26 |
| 1417567371 | Zaweah Luxury Living LLC | Custodial Care Facility | 9129 S 48th Dr, Laveen, AZ 85339-2242 | 2020-08-05 |
| 1932725835 | Oasis Group Home LLC | Custodial Care Facility | 2206 W. Spur Dr., Phoenix, AZ 85085-5752 | 2020-06-17 |
| 1821618679 | Klara's II Adult Care Home | Custodial Care Facility | 2974 E Pony Ct, Gilbert, AZ 85295-3775 | 2020-04-22 |
| 1932728581 | Michael Ford | Custodial Care Facility | 10462 E Abilene Ave, Mesa, AZ 85208-8717 | 2020-04-14 |
| 1588297006 | Marley Adult Healthcare LLC | Custodial Care Facility | 14798 W Georgia Dr, Surprise, AZ 85379-4243 | 2020-02-13 |
| 1841837499 | Gemini Group, LLC | Custodial Care Facility | 5045 E Paradise Ln, Scottsdale, AZ 85254-1045 | 2019-12-03 |
| 1457997744 | Dream Street Care LLC | Custodial Care Facility | 37412 N Dream Street, Carefree, AZ 85377 | 2019-11-21 |
| 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.