Senior Living Options Maryland Gardens, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NCI-046 Issued in AZ

Legal business name

SENIOR LIVING OPTIONS MARYLAND GARDENS, LLC

Practice address

31 W Maryland Ave
Phoenix, AZ 85013-1227

Phone

(602) 265-7484

Fax

(602) 265-0659

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Sean Mockbee

Title

Administrator

Phone

(602) 265-7484

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Maryland Gardens Care Center Doing business as

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1326134107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 W MARYLAND AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850131227",
            "telephone_number": "602-265-7484",
            "fax_number": "602-265-0659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W MARYLAND AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850131227",
            "telephone_number": "602-265-7484",
            "fax_number": "602-265-0659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR LIVING OPTIONS MARYLAND GARDENS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "MOCKBEE",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-265-7484"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AZ",
            "license": "NCI-046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "234731",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maryland Gardens Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christian E Senftleben, LPC
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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 Jun 17, 2008; 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.