NPIMap

Organization Active NPI

Ordinary Lifestyles, LLC

  • Adult Care Home Facility
  • Payson, AZ
National Provider Identifier
1003214370
Registry record updated Dec 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
AL4632H Issued in AZ
Legal business name
ORDINARY LIFESTYLES, LLC
Practice address
401 N Laredo LN
Payson, AZ 85541-4389
Phone
(928) 595-2068
Fax
(888) 673-2528
NPI assigned
Dec 18, 2014
Last updated
Dec 18, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2014

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

Authorized official

Name
Karen Waters
Title
Owner
Phone
(928) 595-2068

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X AL4632H AZ Primary
Adult Care Home Facility 311ZA0620X AL9273H AZ
Adult Care Home Facility 311ZA0620X AL9118H AZ
Adult Care Home Facility 311ZA0620X AL9592H AZ

Addresses

Primary practice location

401 N Laredo LN
Payson, AZ 85541-4389

Mailing address

401 N Laredo LN
Payson, AZ 85541-4389
Phone (928) 595-2068

Other identifiers 1

IdentifierTypeStateIssuer
854100OtherAZAHCCCS ID

National Provider Directory

National Provider Directory
Tax ID family
Ordinary Lifestyles LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418860800000",
    "number": "1003214370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N LAREDO LN",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855414389",
            "telephone_number": "928-595-2068",
            "fax_number": "888-673-2528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N LAREDO LN",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855414389",
            "telephone_number": "928-595-2068",
            "fax_number": "888-673-2528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORDINARY LIFESTYLES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-18",
        "last_updated": "2014-12-18",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-595-2068"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "AZ",
            "license": "AL4632H",
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "AZ",
            "license": "AL9273H",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "AZ",
            "license": "AL9118H",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "AZ",
            "license": "AL9592H",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS ID",
            "identifier": "854100",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Payson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.