ST CHARLES PLACE (NPI# 1861876500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861876500 |
| Entity Type | Organization |
| Organization Name | ST CHARLES PLACE |
| Other Organization Name | ST CHARLES PLACE III |
| Practice Address |
6818 S 16th Pl Phoenix AZ 85042-5714 |
| Practice Telephone | 6022760084 |
| Practice Fax Number | 6025959969 |
| Mailing Telephone | 6022760084 |
| Mailing Fax Number | 6025959969 |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2015-07-13 |
| Authorized Official Name | JAMES WILLIAMS (MANAGER/OWNER) |
| Authorized Official Telephone | 6022760084 |
| Authorized Official Credential | MSW |
| Is Organization Subpart | Y |
| Parent Organization Name | ST CHARLES PLACE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | AL3064H | AZ | Nursing & Custodial Care Facilities |
| Y | 310400000X | Assisted Living Facility | AL 8954H | AZ | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 426933 | 05 |
| Other Name | Type Code |
|---|---|
| st charles place III | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | ST CHARLES PLACE, LLC | 5 Shore Lane, Bay Shore, New York 11706 |
| Street Address |
6818 S 16TH PL |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85042-5714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245420223 | St. Charles Place, LLC | Assisted Living Facility | 6818 S 16th Pl, Phoenix, AZ 85042-5714 | 2007-07-26 |
| 1063895506 | James Williams | Assisted Living Facility | 6818 S 16th Pl, Phoenix, AZ 85042-5714 | 2015-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306443197 | Da Homes LLC | Case Management | 8026 S. 24th Way, Phoenix, AZ 85042 | 2020-10-05 |
| 1144790460 | Ebony House Inc | Substance Abuse Rehabilitation Facility | 6222 S. 13th Street, Phoenix, AZ 85042 | 2018-11-29 |
| 1427538362 | Abigail Mcgrath | Dietitian, Registered | 303 E Baseline Rd Ste 200, Phoenix, AZ 85042 | 2018-08-20 |
| 1174028310 | Olufemi A Omodara | Pharmacist | 7227 S. Central Ave, #1080, Phoenix, AZ 85042 | 2018-03-29 |
| 1720537699 | Mary Youngblood | Registered Nurse | 7210 S 27th Way, Phoenix, AZ 85042 | 2016-10-03 |
| 1922490382 | Brian Zembower | Optometrist | 610 E Baseline Rd Ste C3, Phoenix, AZ 85042 | 2015-02-23 |
| 1417299819 | Robert Murphy Portley | Psychiatry & Neurology | 2320 E Baseline Rd Ste 148-225, Phoenix, AZ 85042 | 2013-03-23 |
| 1972807998 | Obinna Chukwuka Akubukwe | Pharmacist | 6006 S. Central Avenue, Phoenix, AZ 85042 | 2011-01-05 |
| 1104120328 | Gisheys Patient Care LLC | Custodial Care Facility | 7232 South 12th Place, Phoeniz, AZ 85042 | 2011-01-03 |
| 1245463488 | Lois Ann Hammitt | Registered Nurse | 6218 S. 7th Street, Phoenix, AZ 85042 | 2009-09-03 |
| Find all providers in zip 85042 | ||||
| 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 |
|---|---|---|---|---|
| 1942800966 | Yibu Liu | Assisted Living Facility | 3569 E Utopia Rd, Phoenix, AZ 85050-3967 | 2020-10-28 |
| 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 |
| 1881201598 | Latins Home LLC | Assisted Living Facility | 10601 S 42nd St, Phoenix, AZ 85044-1301 | 2020-09-26 |
| 1659987998 | Mehry Lyn Moses | Assisted Living Facility | 1816 E Whitton Ave, Phoenix, AZ 85016-6416 | 2020-09-22 |
| 1417562406 | Briceida Rocha | Assisted Living Facility | 1345 W Atlanta Ave, Phoenix, AZ 85041-3929 | 2020-09-15 |
| 1073127213 | Marlyn Ll Joaquin | Assisted Living Facility | 1349 W Rosemonte Dr, Phoenix, AZ 85027-5444 | 2020-09-04 |
| 1720602832 | Casa De Vida Living LLC | Assisted Living Facility | 7036 W Parkway Dr, Phoenix, AZ 85043-6921 | 2020-06-04 |
| 1689295297 | Raj International LLC | Assisted Living Facility | 4312 E Redwood Ln, Phoenix, AZ 85048-7028 | 2020-05-05 |
| 1285261891 | Sterling Residences, LLC | Assisted Living Facility | 2301 E Lone Cactus Dr, Phoenix, AZ 85024-5507 | 2020-03-24 |
| 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.