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VINEYARD ADULT CARE HOME NPI 1164606620


NPI Information

NPI: 1164606620
Provider Name: VINEYARD ADULT CARE HOME

Doing Business As: SUNRISE ADULT CARE HOME

Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

CLIA Number: 03D2038141

Address:
4415 W CAROL AVE
GLENDALE, AZ
ZIP 85302
Phone: (623) 847-1216
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VINEYARD ADULT CARE HOME is an adult care home custodial care facility in Glendale, AZ. The provider is 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. VINEYARD ADULT CARE HOME NPI is 1164606620. The provider is registered as an organization entity type.
The provider Is Doing Business As Sunrise Adult Care Home.

The provider's business location address is:

4415 W CAROL AVE
GLENDALE, AZ
ZIP 85302-814
Phone: (623) 847-1216
Fax: (623) 847-1216

The provider's authorized official is Cornelia Lupas .
The authorized official title is Administrator and has the following contact phone number (623) 847-1216.

The CLIA number assigned to this NPI record is 03D2038141 - other - health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/19/2007 and was last updated on 1/29/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1311ZA0620XCustodial Care FacilityAdult Care HomeALH-6842ARIZONAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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