JOHN HENRY MARTIN LICO NPI 1003432667

NPI Information

  • NPI: 1003432667
  • Provider Name: JOHN HENRY MARTIN LICO
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Individual
  • Address: 15244 W WATSON LN
    SURPRISE, AZ
    ZIP 85379
  • Phone: (623) 227-9697

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NPI Details

John Henry Martin Lico is an assisted living facility in Surprise, AZ. The provider is 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. John Henry Martin Lico NPI is 1003432667. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

15244 W WATSON LN
SURPRISE, AZ
ZIP 85379-040
Phone: (623) 227-9697

The enumeration date for this NPI number is 6/19/2020 and was last updated on 6/19/2020.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityAL11496HARIZONAYes

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: 11/21/2025

NPI Synchronization or Removal

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