Slo Ridgecrest LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NCI2651 Issued in AZ

Legal business name

SLO RIDGECREST LLC

Doing business as

RidgeCrest Healthcare

Practice address

16640 N 38TH St
Phoenix, AZ 85032-2103

Phone

(602) 482-6671

Fax

(602) 482-3541

NPI assigned

Oct 10, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Colleen Helen Sweet

Title

Managing Member

Phone

(480) 797-9948

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• RidgeCrest Healthcare Doing business as

Locations

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360627200000",
    "number": "1275521627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16640 N 38TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322103",
            "telephone_number": "602-482-6671",
            "fax_number": "602-482-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16640 N 38TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322103",
            "telephone_number": "602-482-6671",
            "fax_number": "602-482-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLO RIDGECREST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2013-02-12",
        "status": "A",
        "authorized_official_last_name": "SWEET",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "HELEN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "480-797-9948",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "AZ",
            "license": "NCI2651",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AZ",
            "license": "NCI2651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "924771",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RidgeCrest Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Skilled Nursing Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; 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.