Elite Assisted Living Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL8356H Issued in AZ

Legal business name

ELITE ASSISTED LIVING HOME

Practice address

15928 W Ironwood Dr
Waddell, AZ 85355-2001

Phone

(602) 743-9924

NPI assigned

Dec 13, 2016

Organization subpart

No

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

Authorized official

Name

Angela Woodworth

Title

Owner

Phone

(602) 743-9924

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ann L Derrick, PT

  • Physical Therapist
  • Peoria, AZ
  • NPI 1205977014
  NPD

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481587200000",
    "number": "1356885164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9559 W PINNACLE VISTA DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853838715",
            "telephone_number": "602-743-9924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15928 W IRONWOOD DR",
            "city": "WADDELL",
            "state": "AZ",
            "postal_code": "853552001",
            "telephone_number": "602-743-9924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE ASSISTED LIVING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-13",
        "last_updated": "2016-12-13",
        "status": "A",
        "authorized_official_last_name": "WOODWORTH",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-743-9924"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL8356H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "498514",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hayleigh Ann Davis
• Brianna Dazzo
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• Maria Celia Fox, FNP
• Devante Gilliam
• Shea Grant
• Guardian Veterans LLC

• Assisted Living Facility in Waddell, AZ
• Providers in Waddell, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.