Renaissance Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL7740H Issued in AZ

Legal business name

RENAISSANCE ASSISTED LIVING

Practice address

4409 W Coplan Farms Rd
Laveen, AZ 85339-7132

Phone

(602) 999-7685

NPI assigned

Nov 12, 2009

Last updated

Nov 12, 2009By 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

Sebastian Smith, RN

Title

Owner

Phone

(602) 999-7685

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257984000000",
    "number": "1013244037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4409 W COPLAN FARMS RD",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853397132",
            "telephone_number": "602-999-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4409 W COPLAN FARMS RD",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853397132",
            "telephone_number": "602-999-7685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-12",
        "last_updated": "2009-11-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SEBASTIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-999-7685",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL7740H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Laveen, AZ
• Providers in Laveen, AZ by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; 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.