NPIMap

Organization Active NPI

Lifestream Complete Senior Living at Northeast Phoenix, Inc.

  • Skilled Nursing Facility
  • Phoenix, AZ
National Provider Identifier
1326592825
Registry record updated Aug 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LIFESTREAM COMPLETE SENIOR LIVING AT NORTHEAST PHOENIX, INC.
Doing business as
LifeStream at Northeast Phoenix Green House 86
Practice address
20802 N. Cave Creek Road
Building 86
Phoenix, AZ 85024
Phone
(602) 569-0508
Fax
(602) 569-0301
NPI assigned
Aug 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2016

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

Authorized official

Name
Donna Taylor
Title
Executive Vice President/Coo
Phone
(623) 933-3333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

20802 N. Cave Creek Road
Building 86
Phoenix, AZ 85024

Mailing address

11555 W. Peoria Avenue
Youngtown, AZ 85363
Phone (623) 933-3333

Other names 1

  • LifeStream at Northeast Phoenix Green House 86 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lifestream at Northeast Phoenix Green House 843 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1470960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470960000000",
    "number": "1326592825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11555 W. PEORIA AVENUE",
            "city": "YOUNGTOWN",
            "state": "AZ",
            "postal_code": "85363",
            "telephone_number": "623-933-3333",
            "fax_number": "623-972-7320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20802 N. CAVE CREEK ROAD",
            "address_2": "BUILDING 86",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85024",
            "telephone_number": "602-569-0508",
            "fax_number": "602-569-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTREAM COMPLETE SENIOR LIVING AT NORTHEAST PHOENIX, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-12",
        "last_updated": "2016-08-12",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT/COO",
        "authorized_official_telephone_number": "623-933-3333"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeStream at Northeast Phoenix Green House 86",
            "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 Aug 12, 2016; 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.