NPIMap

Organization Active NPI

Alpine Villa LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1225697386
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
ALPINE VILLA LLC
Practice address
2144 W Luke Ave
Phoenix, AZ 85015-2319
Phone
(602) 975-1700
NPI assigned
Jun 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Authorized official

Name
Eric Glade Maughan
Title
Administrator/Owner
Phone
(602) 292-2010

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Mental Illness) 3104A0625X
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

2144 W Luke Ave
Phoenix, AZ 85015-2319

Mailing address

8845 W Potter Dr
Peoria, AZ 85382-6428
Phone (602) 292-2010

Other names 1

  • Alpine Villa Luke Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Alpine Villa 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": "1560211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1225697386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8845 W POTTER DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853826428",
            "telephone_number": "602-292-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2144 W LUKE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152319",
            "telephone_number": "602-975-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPINE VILLA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-11",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "MAUGHAN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "GLADE",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "602-292-2010"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alpine Villa Luke",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alpine Villa Luke",
            "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 Oct 21, 2020; 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.