NPIMap

Organization Active NPI

Extended Care Portfolio Multistate Pool Tenant LLC

  • Alzheimer Center (Dementia Center)
  • Phoenix, AZ
National Provider Identifier
1265832299
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Alzheimer Center (Dementia Center)Taxonomy code 311500000X
License
AL6981C Issued in AZ
Legal business name
EXTENDED CARE PORTFOLIO MULTISTATE POOL TENANT LLC
Practice address
16621 N 38TH St
Phoenix, AZ 85032-2102
Phone
(602) 787-0800
Fax
(602) 787-0531
NPI assigned
Aug 27, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Authorized official

Name
Mr. Deepak Israni
Title
Manager
Phone
(619) 296-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Alzheimer Center (Dementia Center) 311500000X AL6981C AZ Primary

Addresses

Primary practice location

16621 N 38TH St
Phoenix, AZ 85032-2102

Mailing address

1775 Hancock St Ste 200
San Diego, CA 92110-2036
Phone (619) 296-9000

Other names 1

  • Pacifica Senior Living Paradise Valley Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Extended Care Portfolio Tenant LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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": "1409097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1265832299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 HANCOCK ST STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102036",
            "telephone_number": "619-296-9000",
            "fax_number": "619-296-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16621 N 38TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322102",
            "telephone_number": "602-787-0800",
            "fax_number": "602-787-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED CARE PORTFOLIO MULTISTATE POOL TENANT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-27",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "ISRANI",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "619-296-9000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "AZ",
            "license": "AL6981C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacifica Senior Living Paradise Valley",
            "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 Sep 12, 2025; 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.