NPIMap

Organization Active NPI

Menlo House

  • Adult Care Home Facility
  • Tucson, AZ
National Provider Identifier
1063519155
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
BH2111 Issued in AZ
Legal business name
MENLO HOUSE
Practice address
1323 W Placita Plata
Tucson, AZ 85745-2722
Phone
(520) 628-8251
Fax
(520) 207-6369
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Elizabeth Mary Ford
Title
Administrator
Phone
(520) 628-8251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X BH2111 AZ Primary

Addresses

Primary practice location

1323 W Placita Plata
Tucson, AZ 85745-2722

Mailing address

1323 W Placita Plata
Tucson, AZ 85745-2722
Phone (520) 628-8251

Other identifiers 1

IdentifierTypeStateIssuer
728967OtherARAHCCCS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063519155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 W PLACITA PLATA",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452722",
            "telephone_number": "520-628-8251",
            "fax_number": "520-207-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1323 W PLACITA PLATA",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452722",
            "telephone_number": "520-628-8251",
            "fax_number": "520-207-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENLO HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "520-628-8251",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "AZ",
            "license": "BH2111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "728967",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • 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.