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NINA NETTLES NPI 1124165469


NPI Information

NPI: 1124165469
Provider Name: NINA NETTLES
Classification: Assisted Living Facility - 3104A0625X
Entity Type: Organization

Specialization: Assisted Living, Mental Illness

Address:
3643 E EMILE ZOLA AVE
PHOENIX, AZ
ZIP 85032
Phone: (602) 867-7500
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NINA NETTLES is an assisted living and mental illness assisted living facility in Phoenix, AZ. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. NINA NETTLES NPI is 1124165469. The provider is registered as an organization entity type.

The provider's business location address is:

3643 E EMILE ZOLA AVE
PHOENIX, AZ
ZIP 85032-219
Phone: (602) 867-7500

The provider's authorized official is Nina Fae Nettles .
The authorized official title is Administrator and has the following contact phone number (602) 867-7500.

The enumeration date for this NPI number is 1/30/2007 and was last updated on 6/16/2008.


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
13104A0625XAssisted Living FacilityAssisted Living, Mental IllnessBH2458ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1BH2458OTHERARIZONASTATE LICENCE
2873936MEDICAIDARIZONA

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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