Primavera Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PRIMAVERA ASSISTED LIVING LLC

Practice address

13644 N 33Rd Ave
Phoenix, AZ 85029-1218

Phone

(951) 907-2289

NPI assigned

Jan 4, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Joy Anne Marie Ibuyan Padron

Title

Owner

Phone

(951) 907-2289

Specialties & licenses 1

Addresses

Other names 1

• Primavera Assisted Living LLC Doing business as

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

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704326400000",
    "number": "1104696897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13644 N 33RD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850291218",
            "telephone_number": "951-907-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13644 N 33RD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850291218",
            "telephone_number": "951-907-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMAVERA ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "PADRON",
        "authorized_official_first_name": "JOY ANNE MARIE",
        "authorized_official_middle_name": "IBUYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-907-2289",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primavera Assisted Living LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Phoenix, AZ
• Providers in Phoenix, 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 Jan 4, 2024; 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.