Casa de Angeles Assisted Living Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL8631H Issued in AZ

Legal business name

CASA DE ANGELES ASSISTED LIVING INC.

Doing business as

Casa de Angeles Assisted Living

Practice address

457 N. Ironwood CT.
Pearce, AZ 85625

Phone

(520) 826-4065

Fax

(520) 826-4065

NPI assigned

Feb 10, 2012

Last updated

Apr 11, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Iliana Lara

Title

Co-Owner

Phone

(520) 873-8419

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Casa de Angeles Assisted Living Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649635200000",
    "number": "1003189754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 726",
            "city": "PEARCE",
            "state": "AZ",
            "postal_code": "85625",
            "telephone_number": "520-826-4065",
            "fax_number": "520-826-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 N. IRONWOOD CT.",
            "city": "PEARCE",
            "state": "AZ",
            "postal_code": "85625",
            "telephone_number": "520-826-4065",
            "fax_number": "520-826-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASA DE ANGELES ASSISTED LIVING INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-10",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A",
        "authorized_official_last_name": "LARA",
        "authorized_official_first_name": "ILIANA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "520-873-8419",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL8631H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "682106",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Casa de Angeles Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Casa de Angeles Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cyndi G Anthony, OTR/L
• Michael J. Bricker, D.D.S.,M.A.G.D.
• Jennifer Ann Campbell, LMT
• Talena Wilson Debaun, CLC, MAC, LAC
• Dr. Troy L Garey DMD, PC
• I Smile at Pearce LLC
• Lazy Horse Ranch
• Jenna Lisa Schaa, M.S. CCC-SLP

• Assisted Living Facility in Pearce, AZ
• Providers in Pearce, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.