Active NPI
Orchid Residential Inc.
- Assisted Living Facility
- Peoria, AZ
National Provider Identifier
1104392349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- ORCHID RESIDENTIAL INC.
- Practice address
- 9580 W Orchid LN
Peoria, AZ 85345-7719 - Phone
- (623) 440-2428
- Fax
- (623) 234-1713
- NPI assigned
- Oct 15, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mavu Jaricha
- Title
- Administrator
- Phone
- (623) 313-0827
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Primary |
Addresses
Primary practice location
9580 W Orchid LN
Peoria, AZ 85345-7719
Mailing address
9305 W Cordes Rd
Tolleson, AZ 85353-1506
Phone (623) 313-0827
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 432938 | Medicaid | AZ |
Other names 1
- Orchid Residential Care
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539561600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1539561600000",
"number": "1104392349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9305 W CORDES RD",
"city": "TOLLESON",
"state": "AZ",
"postal_code": "853531506",
"telephone_number": "623-313-0827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9580 W ORCHID LN",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853457719",
"telephone_number": "623-440-2428",
"fax_number": "623-234-1713"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ORCHID RESIDENTIAL INC.",
"organizational_subpart": "NO",
"enumeration_date": "2018-10-15",
"last_updated": "2018-10-15",
"status": "A",
"authorized_official_last_name": "JARICHA",
"authorized_official_first_name": "MAVU",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "623-313-0827"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "432938",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Orchid Residential Care",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.