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FANAKA ENTERPRISES LLC NPI 1912511999


NPI Information

NPI: 1912511999
Provider Name: FANAKA ENTERPRISES LLC

Doing Business As: LA PAZ ASSISTED LIVING III

Classification: Assisted Living Facility - 3104A0630X
Entity Type: Organization

Specialization: Assisted Living, Behavioral Disturbances

Address:
3925 E 1ST ST
TUCSON, AZ
ZIP 85711
Phone: (520) 771-9971
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FANAKA ENTERPRISES LLC is an assisted living and behavioral disturbances assisted living facility in Tucson, AZ. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. FANAKA ENTERPRISES LLC NPI is 1912511999. The provider is registered as an organization entity type.
The provider Is Doing Business As La Paz Assisted Living Iii.

The provider's business location address is:

3925 E 1ST ST
TUCSON, AZ
ZIP 85711-001
Phone: (520) 771-9971
Fax: (520) 771-9971

The provider's authorized official is Cate Kibera .
The authorized official title is Owner and has the following contact phone number (520) 301-9021.

The enumeration date for this NPI number is 9/7/2020 and was last updated on 7/7/2022.


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
13104A0630XAssisted Living FacilityAssisted Living, Behavioral DisturbancesYes

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
1008631MEDICAIDARIZONA

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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