Pataky Enterprises LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

PATAKY ENTERPRISES LLC

Doing business as

Arizona Care Center
Arizona CareCenter

Practice address

101 Arizona St
New Haven, MO 63068-1210

Phone

(573) 237-4830

Fax

(573) 237-4831

NPI assigned

Sep 5, 2021

Last updated

Sep 5, 2021By 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

Mrs. Jamie Lee Pataky, RN

Title

Co-Owner

Phone

(573) 237-4830

Specialties & licenses 1

Addresses

Other names 2

• Arizona Care Center Doing business as
• Arizona CareCenter Doing business as

Locations

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

{
    "created_epoch": "1630800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630800000000",
    "number": "1245908029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 ARIZONA ST",
            "city": "NEW HAVEN",
            "state": "MO",
            "postal_code": "630681210",
            "telephone_number": "573-237-4830",
            "fax_number": "573-237-4831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ARIZONA ST",
            "city": "NEW HAVEN",
            "state": "MO",
            "postal_code": "630681210",
            "telephone_number": "573-237-4830",
            "fax_number": "573-237-4831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATAKY ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-05",
        "last_updated": "2021-09-05",
        "certification_date": "2021-09-05",
        "status": "A",
        "authorized_official_last_name": "PATAKY",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "573-237-4830",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arizona Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Arizona CareCenter",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jenifer K Moser, DDS
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• Michelle Louise Patke, CCC-SLP
• Tami Pollock
• Destiny Leeanne Pottebaum, MSW
• Pratt's Rexall Drugs, Inc (Pratt's Pharmacy)

• Assisted Living Facility (Mental Illness) in New Haven, MO
• Providers in New Haven, MO by specialty
• Assisted Living Facility (Mental Illness) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2021; 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.