NPIMap

Organization Active NPI

Cornwall Health Systems, Inc

Doing business as Calle Homes 1

  • Adult Care Home Facility
  • Phoenix, AZ
National Provider Identifier
1205977261
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
ALH5269 Issued in AZ
Legal business name
CORNWALL HEALTH SYSTEMS, INC
Doing business as
Calle Homes 1
Practice address
4229 N 82ND Ave
Phoenix, AZ 85033-2332
Phone
(623) 845-0774
Fax
(623) 974-8322
NPI assigned
Feb 10, 2007
Last updated
Sep 28, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Authorized official

Name
Ms. Lorna Ophelia Callender, R.N.
Title
Administrator Manager
Phone
(623) 845-0774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X ALH5269 AZ Primary

Addresses

Primary practice location

4229 N 82ND Ave
Phoenix, AZ 85033-2332

Mailing address

4229 N 82ND Ave
Phoenix, AZ 85033-2332
Phone (623) 845-0774

Other identifiers 1

IdentifierTypeStateIssuer
962086MedicaidAZ

Other names 1

  • Calle Homes 1 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Alternate Homecare2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1171065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190937600000",
    "number": "1205977261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4229 N 82ND AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850332332",
            "telephone_number": "623-845-0774",
            "fax_number": "623-974-8322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4229 N 82ND AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850332332",
            "telephone_number": "623-845-0774",
            "fax_number": "623-974-8322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNWALL HEALTH SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-10",
        "last_updated": "2007-09-28",
        "status": "A",
        "authorized_official_last_name": "CALLENDER",
        "authorized_official_first_name": "LORNA",
        "authorized_official_middle_name": "OPHELIA",
        "authorized_official_title_or_position": "ADMINISTRATOR MANAGER",
        "authorized_official_telephone_number": "623-845-0774",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "AZ",
            "license": "ALH5269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "962086",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Calle Homes 1",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; 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.