Bal-Tip Corp

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

ALH5490 Issued in AZ

Legal business name

BAL-TIP CORP

Doing business as

Bal-Tip Assisted Living

Practice address

3996 N Bowie Rd
Golden Valley, AZ 86413-9211

Phone

(928) 565-3231

Fax

(928) 565-7472

NPI assigned

May 31, 2007

Organization subpart

No

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

Authorized official

Name

Enid Ballentine

Title

Owner-Manager

Phone

(928) 565-3231

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bal-Tip Assisted Living Doing business as

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366643876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3996 N BOWIE RD",
            "city": "GOLDEN VALLEY",
            "state": "AZ",
            "postal_code": "864139211",
            "telephone_number": "928-565-3231",
            "fax_number": "928-565-7472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3996 N BOWIE RD",
            "city": "GOLDEN VALLEY",
            "state": "AZ",
            "postal_code": "864139211",
            "telephone_number": "928-565-3231",
            "fax_number": "928-565-7472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAL-TIP CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BALLENTINE",
        "authorized_official_first_name": "ENID",
        "authorized_official_title_or_position": "OWNER-MANAGER",
        "authorized_official_telephone_number": "928-565-3231"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "AZ",
            "license": "ALH5490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204806",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bal-Tip Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Care Home Facility in Golden Valley, AZ
• Providers in Golden Valley, AZ by specialty
• Adult Care Home Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.