Archie Hendricks Sr Skilled Nursing Facility

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

ARCHIE HENDRICKS SR SKILLED NURSING FACILITY

Doing business as

Tohono O'odham Hospice

Practice address

HC 01 Box 9100
Sells, AZ 85634

Phone

(520) 361-1800

Fax

(520) 361-3656

NPI assigned

Oct 24, 2005

Last updated

Sep 25, 2024By 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

Mr. Ross Wilkoff

Title

Administrator

Phone

(520) 585-5500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tohono O'odham Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073503777. Details of each certification follow.

• CCN 035263 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 035263

Legal name

ARCHIE HENDRICKS SR SKILLED NURSING FACILITY

Doing business as

ARCHIE HENDRICKS SENIOR SKILLED NURSING FACILITY

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Sep 15, 2004

Last certification

Sep 27, 2024

Beds

60

Ownership / control type

Nonprofit Corporation

Organization structure

OtherNon-profit

Enrollment address

HC 01 Box 9100
Federal Route 15 Mile Post 9
Sells, AZ 85634-9744

Nursing home name

ARCHIE HENDRICKS SENIOR SKILLED NURSING FACILITY

Listed as

Archie Hendricks Senior Skilled Nursing FacilityCCN 035263 · All quality measures

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

4 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Sep 15, 2004

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6050.7 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Archie Hendricks Sr Skilled Nursing Facility

  dba Tohono O'Odham Hospice

  • Community Based Hospice Care Agency
  • Sells, AZ
  • NPI 1962653535

  Member Of

  NPD member

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Osaf Ahmed, MD

  • Internal Medicine Physician
  • Chandler, AZ
  • NPI 1396775680
  NPD (past)
• Scott M Bolhack, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Tucson, AZ
  • NPI 1730160573
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Osaf Ahmed, MD

  • Internal Medicine Physician
  • Chandler, AZ
  • NPI 1396775680

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1073503777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 01 BOX 9100",
            "city": "SELLS",
            "state": "AZ",
            "postal_code": "85634",
            "telephone_number": "520-585-5500",
            "fax_number": "520-585-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 01 BOX 9100",
            "city": "SELLS",
            "state": "AZ",
            "postal_code": "85634",
            "telephone_number": "520-361-1800",
            "fax_number": "520-361-3656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHIE HENDRICKS SR SKILLED NURSING FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-24",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "WILKOFF",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "520-585-5500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "917651",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tohono O'odham Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Akdhc, LLC
• Macy Pearl Alexander, PHARMD
• Alfred J. Juan Sr. (AL Transportation Service)
• Michael R Allen, R.PH
• Lynn Marie Anderson-Silvas, RN
• Archie Hendricks Sr Skilled Nursing Facility (Tohono O'odham Elder Assisted Living Residence)
• Archie Hendricks Sr Skilled Nursing Facility (Tohono O'Odham Hospice)
• Archie Hendricks Sr Skilled Nursing Facility (Archie Hendricks Outpatient Rehab)
• Archie Hendricks Sr. Skilled Nursing Fascility (Tohono O'odham Hospice)
• Jonathan Babbitt, PHARM D

• Skilled Nursing Facility in Sells, AZ
• Providers in Sells, AZ by specialty
• Skilled Nursing Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.