AZ ADVANCED CARE LLC (NPI# 1447645833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447645833 |
| Entity Type | Organization |
| Organization Name | AZ ADVANCED CARE LLC |
| Other Organization Name | WEST LANE HOME |
| Practice Address |
3137 W Lane Ave Phoenix AZ 85051-6522 |
| Practice Telephone | 6023320780 |
| Practice Fax Number | 8775172224 |
| Mailing Telephone | 6023320780 |
| Mailing Fax Number | 8775172224 |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2015-04-02 |
| Authorized Official Name | REBECCA T. SIDDIQUI (ADMINISTRATOR) |
| Authorized Official Telephone | 6023320780 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
AL9510H | AZ | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 963085 | 05 |
| Other Name | Type Code |
|---|---|
| West Lane Home | Doing Business As Name - Organization |
| Street Address |
3137 W LANE AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85051-6522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184250383 | Jhajaira Elizabeth Cadenas | Optometrist | 3937 W Northview Ave, Phoenix, AZ 85051 | 2020-03-19 |
| 1083270854 | Vision With Wings | Voluntary or Charitable | 9617 N. Metro Pkwy West, Ste. 1214, Phoeniz, AZ 85051 | 2019-05-16 |
| 1417510405 | Applied Behavioral Interventions Pllc | Dietitian, Registered | 10000 N. 31st Avenue Ste. A107, Phoenix, AZ 85051 | 2019-04-16 |
| 1558832683 | Liberty Home LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 9649 N 36th Ave, Phoenix, AZ 85051 | 2018-12-16 |
| 1518459080 | Addie Robin Diroberts | Counselor | 10240 W. 31st Ave, Phoenix, AZ 85051 | 2018-05-31 |
| 1093239816 | Jason Allan Parker | Licensed Practical Nurse | 3310 West Cheryl Drive, Phoenix, AZ 85051 | 2017-08-02 |
| 1588019145 | Vanessa Eloise Hernandez | Counselor | 10000 N. 31st Ave., Applied Behavioral Interventions, Pllc, Phoenix, AZ 85051 | 2016-05-02 |
| 1912230178 | Mozelle Barr Martin | Counselor | 3734 W. Vista Ave., Phoenix, AZ 85051 | 2009-09-04 |
| 1316184542 | Tom Sowash Od & Associates PC | Optometrist | 9617 North Parkway West, #1160, Phoenix, AZ 85051 | 2009-01-09 |
| 1609026913 | Luma Z Sayegh | Dentist | 7012 N 35th Ave, Suite 1, Phoenix, AZ 85051 | 2008-09-23 |
| Find all providers in zip 85051 | ||||
| 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 |
|---|---|---|---|---|
| 1932725835 | Oasis Group Home LLC | Custodial Care Facility | 2206 W. Spur Dr., Phoenix, AZ 85085-5752 | 2020-06-17 |
| 1770125403 | Desert Gem Assisted Living Facility, LLC | Custodial Care Facility | 3236 W. Eugie Avenue, Phoenix, AZ 85029 | 2019-10-15 |
| 1124679931 | Lovin Touch LLC | Custodial Care Facility | 4130 W Northern Ave, Phoenix, AZ 85051-5765 | 2019-09-23 |
| 1164070819 | Love Shines Behavioral Health Homes LLC | Custodial Care Facility | 16401 N 39th Pl, Phoenix, AZ 85032-3246 | 2019-08-27 |
| 1386147262 | Desert View Assisted Living | Custodial Care Facility | 9401 N 36 Ave, Phoenix, AZ 85051-3305 | 2018-03-16 |
| 1699289215 | Desert Springs Care Home L.L.C. | Custodial Care Facility | 3445 W Acoma Dr, Phoenix, AZ 85053-5620 | 2017-11-17 |
| 1750817763 | Flerida Cabatic | Custodial Care Facility | 27413 N 23rd Dr, Phoenix, AZ 85085-4708 | 2017-05-11 |
| 1679947238 | Garcia's Assisted Living Home LLC | Custodial Care Facility | 2742 E Pueblo Avenue, Phoenix, AZ 85040 | 2015-11-19 |
| 1447643069 | Caring Haven Homes LLC | Custodial Care Facility | 420 W Sequoia Dr, Phoenix, AZ 85027-4727 | 2015-03-05 |
| 1346645702 | Rebecca Siddiqui | Custodial Care Facility | 4113 W Hayward Ave, Phoenix, AZ 85051-5751 | 2014-10-28 |
| Find all providers in PHOENIX | ||||
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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.