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GOLDWATER LEGACY ASSISTED LIVING LLC NPI 1841782638


NPI Information

NPI: 1841782638
Provider Name: GOLDWATER LEGACY ASSISTED LIVING LLC

Former Legal Business Name: GOLD WATER ASSISTED LIVING II

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
6640 W PINNACLE PEAK RD
GLENDALE, AZ
ZIP 85310
Phone: (480) 544-9334
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GOLDWATER LEGACY ASSISTED LIVING LLC is an assisted living facility in Glendale, 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. GOLDWATER LEGACY ASSISTED LIVING LLC NPI is 1841782638. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Gold Water Assisted Living Ii.

The provider's business location address is:

6640 W PINNACLE PEAK RD
GLENDALE, AZ
ZIP 85310-409
Phone: (480) 544-9334

The provider's authorized official is Stephen Tohatan .
The authorized official title is Administrator and has the following contact phone number (480) 544-9334.

The enumeration date for this NPI number is 6/6/2018 and was last updated on 6/16/2018.


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
1310400000XAssisted Living FacilityAL9797HARIZONAYes

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
10OTHERPRIVATE PAY

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: 11/14/2023

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