GOLDWATER LEGACY ASSISTED LIVING LLC (NPI# 1841782638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841782638 |
| Entity Type | Organization |
| Organization Name | GOLDWATER LEGACY ASSISTED LIVING LLC |
| Other Organization Name | GOLD WATER ASSISTED LIVING II |
| Practice Address |
6640 W Pinnacle Peak Rd Glendale AZ 85310-3409 |
| Practice Telephone | 4805449334 |
| Mailing Telephone | 4805449334 |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | STEPHEN TOHATAN (ADMINISTRATOR) |
| Authorized Official Telephone | 4805449334 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL9797H | AZ | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| GOLD WATER ASSISTED LIVING II | Former Legal Business Name - Organization |
| Street Address |
6640 W PINNACLE PEAK RD |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85310-3409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316597479 | Diana Olp | Technician | 5003 W. Creedance Blvd., Glendale, AZ 85310 | 2019-09-19 |
| 1972091940 | Daniel Hamilton | Physician Assistant | 4946 W Electra Ln, Glendale, AZ 85310 | 2018-04-25 |
| 1265958615 | Rose Ilene Wesol | Registered Nurse | Copper Creek Elementary School, 7071 W Hillcrest Blvd, Glendale, AZ 85310 | 2017-08-17 |
| 1730510785 | Otilia Muresan | Preferred Provider Organization | 22365 N 69th Ave, Glendale, AZ 85310 | 2013-12-02 |
| 1811129026 | Hope Healthcare, LLC | Home Health | 6022 W Robin Ln, Glendale, AZ 85310 | 2009-08-20 |
| 1467699777 | Desert Winds Behavioral Health LLC | Case Management | 6127 W. Westwind Dr., Glendale, AZ 85310 | 2009-01-08 |
| 1083835235 | Amy Marie Mccluer | Occupational Therapy Assistant | 7071 W. Hillcrest Blvd., Glendale, AZ 85310 | 2007-05-02 |
| 1346364866 | Camelia Igna | Assisted Living Facility | 6127 W Westwind Dr, Glendale, AZ 85310 | 2007-03-19 |
| 1124185228 | Daas Healthcare, LLC | Internal Medicine | 19841 N.27th Ave, Suite 300, Phoenix, AZ 85310 | 2007-01-02 |
| 1467545160 | Rgl Development, LLC | Assisted Living Facility | 6735 West Hillcrest Blvd, Glendale, AZ 85310 | 2006-10-02 |
| Find all providers in zip 85310 | ||||
| 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 |
|---|---|---|---|---|
| 1083228316 | Unique Family To Family Adult Care Home, LLC | Assisted Living Facility | 6981 W Villa Hermosa, Glendale, AZ 85310-5855 | 2020-09-03 |
| 1225673759 | Trinity Assisted Living | Assisted Living Facility | 4541 W Paradise Ln, Glendale, AZ 85306-2729 | 2019-11-07 |
| 1952954489 | Jubilee In The Desert, LLC | Assisted Living Facility | 4321 W Cholla St, Glendale, AZ 85304-3531 | 2019-07-23 |
| 1962054536 | Vema Corporation | Assisted Living Facility | 4802 W Gelding Dr, Glendale, AZ 85306-4438 | 2019-07-12 |
| 1013487180 | Ludovica Rodica Malutan | Assisted Living Facility | 5019 W Paradise Ln, Glendale, AZ 85306-2655 | 2018-11-30 |
| 1144790601 | Terra Pointe Care, LLC | Assisted Living Facility | 5330 W Union Hills Dr, Glendale, AZ 85308-1311 | 2018-11-27 |
| 1316433493 | Andrei Martin | Assisted Living Facility | 6338 W Port Royale Ln, Glendale, AZ 85306-3260 | 2018-07-02 |
| 1932627494 | Dennis J Tan | Assisted Living Facility | 6979 W Cactus Wren Dr, Glendale, AZ 85303-2684 | 2017-09-05 |
| 1568984037 | Angels Paradise Care Home 2, LLC | Assisted Living Facility | 5582 W Becker Ln, Glendale, AZ 85304-3866 | 2017-07-17 |
| 1093254435 | Los Feliz Residential Care Center Inc. | Assisted Living Facility | 205 E Los Feliz Rd, Glendale, CA 91205-3118 | 2017-02-17 |
| Find all providers in GLENDALE | ||||
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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.