La Casa Serena

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

AL6954 Issued in AZ

Legal business name

LA CASA SERENA

Practice address

324 East 1St Street
Eagar, AZ 85925-0609

Phone

(928) 333-0151

Fax

(928) 333-0154

NPI assigned

Apr 15, 2008

Last updated

Apr 15, 2008By 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. Eric Lee Hamblin

Title

Owner

Phone

(928) 333-0151

Specialties & licenses 1

Addresses

Tax ID family

Hinkson Assisted Living Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Hinkson Assisted Living Center

  • Assisted Living Facility
  • Saint Johns, AZ
  • NPI 1578794442
  NPD tax ID

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1073787768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 E 1ST STREET",
            "city": "EAGAR",
            "state": "AZ",
            "postal_code": "859250609",
            "telephone_number": "928-333-0151",
            "fax_number": "928-333-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 EAST 1ST STREET",
            "city": "EAGAR",
            "state": "AZ",
            "postal_code": "859250609",
            "telephone_number": "928-333-0151",
            "fax_number": "928-333-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA CASA SERENA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "HAMBLIN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-333-0151",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "AZ",
            "license": "AL6954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayle L Haws, O.D.
• James Heap
• Steven Paul Heap, OD
• Christine Jackson, MD
• Jim W Crosby DDS PC
• Nicholas Talbert Mallory, DMD
• Candice Marissa Matthews, RDH
• Brooke Arlene McCarthy, OTRL
• Winslow James McNeill, D.C.
• Nazcare, Inc Power Recovery Center

• Health Maintenance Organization in Eagar, AZ
• Providers in Eagar, AZ by specialty
• Health Maintenance Organization in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.