NPIMap

Organization Active NPI

Ac Assisted Living

Doing business as Ac Assisted Living 4 LLC

  • Assisted Living Facility
  • Globe, AZ
National Provider Identifier
1225659337
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
AC ASSISTED LIVING
Doing business as
Ac Assisted Living 4 LLC
Practice address
675 S Eleventh St
Globe, AZ 85501-1333
Phone
(480) 203-5862
NPI assigned
Apr 29, 2020
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Pat Overton
Title
Admin Assist
Phone
(310) 704-3504

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU Primary

Addresses

Primary practice location

675 S Eleventh St
Globe, AZ 85501-1333

Mailing address

675 S Eleventh St
Globe, AZ 85501-1333
Phone (480) 203-5862

Other identifiers 1

IdentifierTypeStateIssuer
AL11475HMedicaidAZ

Other names 1

  • AC ASSISTED LIVING 4 LLC Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL HELENN754@GMAIL.COM Direct AC Assisted Living

National Provider Directory

National Provider Directory
Tax ID family
Ac Assisted Living 5 LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1588118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1225659337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 S ELEVENTH ST",
            "city": "GLOBE",
            "state": "AZ",
            "postal_code": "855011333",
            "telephone_number": "480-203-5862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 S ELEVENTH ST",
            "city": "GLOBE",
            "state": "AZ",
            "postal_code": "855011333",
            "telephone_number": "480-203-5862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AC ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-29",
        "last_updated": "2023-11-27",
        "certification_date": "2021-02-24",
        "status": "A",
        "authorized_official_last_name": "OVERTON",
        "authorized_official_first_name": "PAT",
        "authorized_official_title_or_position": "ADMIN ASSIST",
        "authorized_official_telephone_number": "310-704-3504"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AL11475H",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "HELENN754@GMAIL.COM",
            "affiliation": "Y",
            "affiliationName": "AC Assisted Living",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "410 W Euclid Ave",
            "city": "Globe",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "855012412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "AC ASSISTED LIVING 4 LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Globe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.