St Walter Group Home LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ST WALTER GROUP HOME LLC

Practice address

8650 S Los Feliz Dr
Tempe, AZ 85284-2583

Phone

(805) 878-9914

NPI assigned

Apr 15, 2021

Last updated

Apr 15, 2021By 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

Welyn Mormino

Title

Administrator

Phone

(805) 878-9914

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618444800000",
    "number": "1063093623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8650 S LOS FELIZ DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852842583",
            "telephone_number": "805-878-9914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8650 S LOS FELIZ DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852842583",
            "telephone_number": "805-878-9914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST WALTER GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-15",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A",
        "authorized_official_last_name": "MORMINO",
        "authorized_official_first_name": "WELYN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "805-878-9914"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jayashree Srinivasan, DMD
• Ssa (transportation)
• St Lukes Medical Center LP
• St Marks Medical
• Robert Bruce St Pierre, M.A. EDUC. COUNSELIN
• St Walter LLC (St Walter Group Home)
• Stability Assist
• Samantha Stacherski
• Stacy K Sledge, MC, LPC, PLLC (Iridescent Counseling Centers)
• Carina Stafford, MT-BC

• Assisted Living Facility in Tempe, AZ
• Providers in Tempe, 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 15, 2021; 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.