Peppertree Quilt, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL4725C Issued in AZ

Legal business name

PEPPERTREE QUILT, LLC

Practice address

10420 N 89TH Ave
Peoria, AZ 85345-6453

Phone

(623) 878-5115

NPI assigned

Apr 18, 2012

Organization subpart

No

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

Authorized official

Name

Thomas J Witt

Title

Manager

Phone

(505) 797-8735

Specialties & licenses 1

Addresses

Other names 1

• Peppertree Square Assisted Living Doing business as

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334707200000",
    "number": "1235496902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5353 WYOMING BLVD NE",
            "address_2": "SUITE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093132",
            "telephone_number": "505-797-8735",
            "fax_number": "505-797-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10420 N 89TH AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853456453",
            "telephone_number": "623-878-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEPPERTREE QUILT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-18",
        "last_updated": "2012-04-18",
        "status": "A",
        "authorized_official_last_name": "WITT",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "505-797-8735"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL4725C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peppertree Square Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Peoria, AZ
• Providers in Peoria, 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 Apr 18, 2012; 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.