Holbrook Senior Citizens Association

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ALC 4486 Issued in AZ

Legal business name

HOLBROOK SENIOR CITIZENS ASSOCIATION

Doing business as

Holbrook Extended Care Facility

Practice address

216 Joy Nevin Ave
Holbrook, AZ 86025-2924

Phone

(928) 524-2344

Fax

(928) 524-3603

NPI assigned

Jan 22, 2007

Last updated

Aug 22, 2020By 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

Miss Mary Lisa Salazar

Title

Administrator

Phone

(928) 524-2344

Specialties & licenses 1

Addresses

Other names 1

• Holbrook Extended Care Facility Doing business as

Tax ID family

Holbrook Extended Care Facility3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Holbrook Senior Citizens Association

  • Assisted Living Facility
  • Holbrook, AZ
  • NPI 1548505357
  NPD tax ID
• Holbrook Senior Citizens Association

  • PACE Provider Organization
  • Holbrook, AZ
  • NPI 1730224379
  NPD tax ID

Locations

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023162807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 580",
            "city": "HOLBROOK",
            "state": "AZ",
            "postal_code": "860250580",
            "telephone_number": "928-524-2344",
            "fax_number": "928-524-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 JOY NEVIN AVE",
            "city": "HOLBROOK",
            "state": "AZ",
            "postal_code": "860252924",
            "telephone_number": "928-524-2344",
            "fax_number": "928-524-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLBROOK SENIOR CITIZENS ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SALAZAR",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "LISA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "928-524-2344",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "ALC 4486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holbrook Extended Care Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Ann Henry, PA-C
• Karen Crystal Hernandez
• Gretchen Elizabeth Herndon, MA, LPC
• Jessica Ann Schauer Herrera, CCC-SLP
• Holbrook EMS Inc.
• Holbrook Senior Citizens Association
• Holbrook Senior Citizens Association
• Holbrook Unified School District #3
• Holbrook Urgent Care, LLC
• Randolph Scott Hollingsworth, LPC/:ISAC

• Assisted Living Facility in Holbrook, AZ
• Providers in Holbrook, 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 Aug 22, 2020; 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.