NPIMap

Organization Active NPI

Providence Legacy Assisted Living

  • Assisted Living Facility
  • Queen Creek, AZ
National Provider Identifier
1285946475
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL7937 Issued in AZ
Legal business name
PROVIDENCE LEGACY ASSISTED LIVING
Practice address
4812 E Meadow Mist LN
Queen Creek, AZ 85140-5222
Phone
(480) 388-1151
NPI assigned
Jul 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

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

Authorized official

Name
Jinette Lanoix
Title
Owner/Manager
Phone
(480) 388-1151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL7937 AZ Primary

Addresses

Primary practice location

4812 E Meadow Mist LN
Queen Creek, AZ 85140-5222

Mailing address

4812 E Meadow Mist LN
Queen Creek, AZ 85140-5222

National Provider Directory

National Provider Directory
Tax ID family
Providence Legacy Assisted Living2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1278374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278374400000",
    "number": "1285946475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4812 E MEADOW MIST LN",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851405222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4812 E MEADOW MIST LN",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851405222",
            "telephone_number": "480-388-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE LEGACY ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-06",
        "last_updated": "2010-07-06",
        "status": "A",
        "authorized_official_last_name": "LANOIX",
        "authorized_official_first_name": "JINETTE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "480-388-1151"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL7937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; 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.