Agave Group, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL7851H Issued in AZ

Legal business name

AGAVE GROUP, LLC

Practice address

9777 E Ocotillo Rim TRL
Vail, AZ 85641-2142

Phone

(520) 444-3354

NPI assigned

May 6, 2011

Organization subpart

No

Name

Mr. Alejandro Prieto, CERTIFIED CAREGIVER

Title

Owner

Phone

(520) 444-3354

Locations

• Ocotillo Preserve Assisted Living Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 6, 2011.

{
    "created_epoch": "1304640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304640000000",
    "number": "1295027399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9777 E OCOTILLO RIM TRL",
            "city": "VAIL",
            "state": "AZ",
            "postal_code": "856412142",
            "telephone_number": "520-444-3354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9777 E OCOTILLO RIM TRL",
            "city": "VAIL",
            "state": "AZ",
            "postal_code": "856412142",
            "telephone_number": "520-444-3354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAVE GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-06",
        "last_updated": "2011-05-06",
        "status": "A",
        "authorized_official_last_name": "PRIETO",
        "authorized_official_first_name": "ALEJANDRO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-444-3354",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CERTIFIED CAREGIVER"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL7851H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ocotillo Preserve Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Vail, AZ
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; 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.