SKYLARK ACH LLC (NPI# 1952781247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952781247 |
| Entity Type | Organization |
| Organization Name | SKYLARK ACH LLC |
| Practice Address |
12034 N 46th Ln Glendale AZ 85304-3012 |
| Practice Telephone | 6237761477 |
| Mailing Telephone | 6237761477 |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2015-06-02 |
| Authorized Official Name | PAUL V PETRINI (OWNER) |
| Authorized Official Telephone | 6024863001 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities | ||
| N | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
Nursing & Custodial Care Facilities | ||
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Street Address |
12034 N 46TH LN |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85304-3012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386254027 | J & B Assisted Living, Inc. D/b/a J & B Behavioral Health II | Substance Abuse Rehabilitation Facility | 6613 W. Pershing Avenue, Glendale, AZ 85304 | 2020-08-07 |
| 1194214015 | Vema Corporation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4309 W Corrine Dr, Glendale, AZ 85304 | 2018-05-07 |
| 1962929224 | Glendale Surgery Center | Clinic/Center | 11851 North 51st Ave, Suite G, Glendale, AZ 85304 | 2017-08-28 |
| 1073941092 | Megan Lorenzen | Occupational Therapist | 5834 W. Bloomfield Rd., Glendale, AZ 85304 | 2013-10-30 |
| 1396178380 | Danielle Marie Wiles | Registered Nurse | 12901 W. 63rd Avenue, Glendale, AZ 85304 | 2013-08-14 |
| 1780017848 | Pedram Nazari | Pharmacist | 4811 North 83rd Avenue, Glendale, AZ 85304 | 2013-08-13 |
| 1740558022 | Krunal Patel | Obstetrics & Gynecology | 5605 W Eugie Ave Ste 111, Glendale, AZ 85304 | 2011-12-01 |
| 1730499609 | Laura A Truax | Physician Assistant | 11851 N. 51st Ave, Ste F-110, Glendale, AZ 85304 | 2010-10-13 |
| 1760698419 | Suhir Bitar | Pediatrics | 13625 N 59th Ave, Glendale, AZ 85304 | 2007-05-16 |
| 1497967293 | Pam Rubbone | Psychologist | 4650 West Sweetwater Ave., Glendale, AZ 85304 | 2007-05-04 |
| Find all providers in zip 85304 | ||||
| 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 |
| 1841782638 | Goldwater Legacy Assisted Living LLC | Assisted Living Facility | 6640 W Pinnacle Peak Rd, Glendale, AZ 85310-3409 | 2018-06-06 |
| 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 |
| 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.