NPIMap

Organization Active NPI

1203 Palloverde LLC

  • Adult Day Care Clinic/Center
  • Chandler, AZ
National Provider Identifier
1114233079
Registry record updated Aug 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
AL7815H Issued in AZ
Legal business name
1203 PALLOVERDE LLC
Practice address
1203 W Palo Verde Dr
Chandler, AZ 85224-2358
Phone
(202) 288-0422
NPI assigned
Aug 28, 2010
Last updated
Aug 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2010

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

Authorized official

Name
Mr. Brian Hackett
Title
President
Phone
(202) 288-0422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X AL7815H AZ Primary

Addresses

Primary practice location

1203 W Palo Verde Dr
Chandler, AZ 85224-2358

Mailing address

1203 W Palo Verde Dr
Chandler, AZ 85224-2358
Phone (202) 288-0422

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1282953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282953600000",
    "number": "1114233079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 W PALO VERDE DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852242358",
            "telephone_number": "202-288-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 W PALO VERDE DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852242358",
            "telephone_number": "202-288-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1203 PALLOVERDE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-28",
        "last_updated": "2010-08-28",
        "status": "A",
        "authorized_official_last_name": "HACKETT",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "202-288-0422",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "AZ",
            "license": "AL7815H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2010; 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.