Individual provider Active NPI

Lavinia E Mateescu, OWNER, MANAGER

  • Assisted Living Facility
  • Glendale, AZ
National Provider Identifier
1346079043
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL12960H Issued in AZ
Practice address
18120 N 53Rd LN
Glendale, AZ 85308-1325
Phone
(623) 262-5388
NPI assigned
Jul 31, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL12960H AZ Primary

Addresses

Primary practice location

18120 N 53Rd LN
Glendale, AZ 85308-1325

Mailing address

5250 E Carolina Dr
Scottsdale, AZ 85254-1732
Phone (623) 262-5388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AL12960HAZMDAssisted Living Facility

NPI Registry JSON

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1346079043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 E CAROLINA DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852541732",
            "telephone_number": "623-262-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18120 N 53RD LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081325",
            "telephone_number": "623-262-5388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEESCU",
        "first_name": "LAVINIA",
        "middle_name": "E",
        "credential": "OWNER, MANAGER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL12960H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.