Litchfield Terrace Assisted Living Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LITCHFIELD TERRACE ASSISTED LIVING HOME

Doing business as

Litchfield Terrace Assisted Living Home

Practice address

13850 W Blossom Way
Litchfield Park, AZ 85340-4261

Phone

(623) 248-0542

Fax

(623) 248-0542

NPI assigned

Jun 22, 2022

Last updated

Jun 22, 2022By 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

Nicole Suprien

Title

Manager

Phone

(702) 292-9169

Specialties & licenses 1

Addresses

Other names 1

• LITCHFIELD TERRACE ASSISTED LIVING HOME Doing business as

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1174254858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13850 W BLOSSOM WAY",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853404261",
            "telephone_number": "623-248-0542",
            "fax_number": "623-248-0542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13850 W BLOSSOM WAY",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853404261",
            "telephone_number": "623-248-0542",
            "fax_number": "623-248-0542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITCHFIELD TERRACE ASSISTED LIVING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "SUPRIEN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "702-292-9169"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LITCHFIELD TERRACE ASSISTED LIVING HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Roger Dayton Livingood, DDS
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• Assisted Living Facility in Litchfield Park, AZ
• Providers in Litchfield Park, 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 Jun 22, 2022; 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.