Active NPI
Mihaela Prunean
- Assisted Living Facility
- Glendale, AZ
National Provider Identifier
1154925568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- AL11643H
- Practice address
- 6403 W Sandra Ter
Glendale, AZ 85306-1625 - Phone
- (623) 882-6545
- Fax
- (623) 537-4010
- NPI assigned
- Nov 25, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | |||
| Assisted Living Facility | 310400000X | AL11643H | AZ | Primary |
Addresses
Primary practice location
6403 W Sandra Ter
Glendale, AZ 85306-1625
Mailing address
6403 W Sandra Ter
Glendale, AZ 85306-1625
Phone (623) 882-6545
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL11643H | AZ | MD | Assisted Living Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620345600000",
"number": "1154925568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6403 W SANDRA TER",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853061625",
"telephone_number": "623-882-6545",
"fax_number": "623-537-4010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6403 W SANDRA TER",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853061625",
"telephone_number": "623-882-6545",
"fax_number": "623-537-4010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUNEAN",
"first_name": "MIHAELA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-25",
"last_updated": "2021-05-07",
"certification_date": "2021-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": null,
"license": null,
"primary": false
},
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "AZ",
"license": "AL11643H",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.