TWILIGHT HAVEN III (NPI# 1821355215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821355215 |
| Entity Type | Organization |
| Organization Name | TWILIGHT HAVEN III |
| Practice Address |
233 S. 123rd Dr. Avondale AZ 85323-8043 |
| Practice Telephone | 6232344034 |
| Practice Fax Number | 6232344525 |
| Mailing Telephone | 6232344034 |
| Mailing Fax Number | 6232344525 |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2012-04-23 |
| Authorized Official Name | MRS. JUSTYNA J CHATKOWSKI (CAREGIVER) |
| Authorized Official Telephone | 6028194951 |
| Is Organization Subpart | Y |
| Parent Organization Name | TWILIGHT HAVEN - ASSISTED LIVING HOME |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 372600000X | Adult Companion | AL85714 | AZ | Nursing Service Related Providers |
| Street Address |
233 S. 123RD DR. |
| City | AVONDALE |
| State | AZ |
| Zip Code | 85323-8043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932663994 | Bridgewater Avondale Operations, LLC | Assisted Living Facility | 295 E Van Buren Street, Avondale, AZ 85323 | 2019-01-24 |
| 1104309152 | Carlos Sifuentes | Physical Therapist | 10750 W Mcdowell Rd., Ste. B-210, Avondale, AZ 85323 | 2018-09-14 |
| 1225534688 | Dayna Sue Kaepp | Registered Nurse | 3300 N. Santa Fe Trail, Avondale, AZ 85323 | 2018-04-04 |
| 1407376700 | Amanda Lynn Radcliffe | Nurse Practitioner | 824 N. 99th Ave Ste 108, Avondale, AZ 85323 | 2017-06-27 |
| 1093253361 | Aquatic-n-writing Rehad | Home Health | 12355 West Cocopah Street, Avondale, AZ 85323 | 2017-02-07 |
| 1750838348 | Annette A Alvarez | Specialist/Technologist | 295 W Western Avenue, Avondale, AZ 85323 | 2016-09-01 |
| 1649726886 | Michelle R Dotson | Contractor | 12115 W Van Buren St Apt 1924, Avondale, AZ 85323 | 2016-08-28 |
| 1619370756 | Amanda Mann | Physical Therapy Assistant | 12804 West Hildalgo, Avondale, AZ 85323 | 2014-10-03 |
| 1326459306 | Ma Caubalejo | Physical Therapist | 350 East La Canada Blvd, Avondale, AZ 85323 | 2014-05-13 |
| 1093139545 | Mark Salvador | Physical Therapy Assistant | 11722 W. Mountain View Dr., Avondale, AZ 85323 | 2014-02-04 |
| Find all providers in zip 85323 | ||||
| Taxonomy Code | 372600000X |
| Grouping | Nursing Service Related Providers |
| Classification | Adult Companion |
| An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376013326 | Jimmy Lee Ellis | Adult Companion | 105 N Links Dr Apt 1061, Avondale, AZ 85323-3046 | 2018-12-03 |
| 1679069025 | Matthew Odishoo | Adult Companion | 2114 S 118th Ave, Avondale, AZ 85323-7643 | 2018-07-09 |
| 1669717468 | Eleonora Kaczmarek | Adult Companion | 2505 S 116th Ave, Avondale, AZ 85323 | 2012-12-05 |
| 1154658219 | Irena Chatkowski | Adult Companion | 2302 S. 113th Ave, Avondale, AZ 85323 | 2009-11-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487262465 | Charles Ogu | Adult Companion | 6638 S 6th Ave, Phoenix, AZ 85041-5764 | 2020-07-16 |
| 1841818887 | Arizona Heartlands Home Care, LLC | Adult Companion | 14626 W. Wethersfield Rd, Surprise, AZ 85379 | 2020-07-07 |
| 1467073684 | Jasmin Zapatero | Adult Companion | 3816 S 74th Dr, Phoenix, AZ 85043-7589 | 2020-04-28 |
| 1932729944 | Tamitha Green | Adult Companion | 3202 W Bell Rd, Phoenix, AZ 85053-7507 | 2020-04-20 |
| 1942851217 | James Loeber | Adult Companion | 2890 Edgewood Dr, Lake Havasu City, AZ 86406-7777 | 2019-09-26 |
| 1265904775 | Denise Turner'coleman | Adult Companion | 7409 S 39th Dr, Phoenix, AZ 85041-6002 | 2018-12-21 |
| 1912484890 | Trillium Home Care, LLC | Adult Companion | 2345 E Thomas Rd Ste 201, Phoenix, AZ 85016-7818 | 2018-07-24 |
| 1760916647 | Amazing Comfort Home LLC | Adult Companion | 1670 E Carla Vista Dr, Chandler, AZ 85225-5268 | 2017-04-17 |
| 1407299233 | Anne Bernadette Hansen | Adult Companion | 1526 Acklin Drive, Prescott, AZ 86301 | 2013-04-11 |
| 1679828875 | Larry B. Yazzie | Adult Companion | 9 Miles East of Pinon Bashas, Pinon, AZ 86510-1209 | 2012-07-13 |
| 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.