Windsor Maryland Gardens, LLC

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

AL8829C Issued in AZ

Legal business name

WINDSOR MARYLAND GARDENS, LLC

Doing business as

Maryland Gardens Care Center

Practice address

31 W Maryland Ave
Phoenix, AZ 85013-1227

Phone

(602) 265-7484

Fax

(602) 279-6030

NPI assigned

Jan 14, 2013

Last updated

Jan 14, 2013By 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

Sean Mockbee

Title

Executive Director

Phone

(602) 265-7484

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Maryland Gardens Care Center Doing business as

Locations

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

{
    "created_epoch": "1358121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358121600000",
    "number": "1225375033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 W MARYLAND AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850131227",
            "telephone_number": "602-265-7484",
            "fax_number": "602-279-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W MARYLAND AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850131227",
            "telephone_number": "602-265-7484",
            "fax_number": "602-279-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDSOR MARYLAND GARDENS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-14",
        "last_updated": "2013-01-14",
        "status": "A",
        "authorized_official_last_name": "MOCKBEE",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "602-265-7484"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "AZ",
            "license": "AL8829C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "768633",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maryland Gardens Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicholas Burke Windauer, DMD
• Rachel Windham
• Robert Windisch Jr., MD
• Daniel James Windschill, DO
• Windsor Encanto Palms, LLC (Encanto Palms Assisted Living)
• Windsor Maryland Gardens, LLC (Maryland Gardens Care Center)
• Windsor Ridgecrest, LLC (Ridecrest Healthcare)
• Mara L Windsor, D.O.
• Billie Winegard
• Heather Winegard

• Alzheimer Center (Dementia Center) in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Alzheimer Center (Dementia Center) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; 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.