Organization Active NPI

La Solana Care and Rehab, Inc

  • Skilled Nursing Facility
  • Douglas, AZ
National Provider Identifier
1366681520
Registry record updated Feb 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NCI-388 Issued in AZ
Legal business name
LA SOLANA CARE AND REHAB, INC
Practice address
1400 N San Antonio Ave
Douglas, AZ 85607-2434
Phone
(520) 364-7937
Fax
(520) 805-9146
NPI assigned
Feb 11, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2009

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

Authorized official

Name
Mr. William Scott Thomas
Title
Systems Administrator
Phone
(801) 296-5106

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NCI-388 AZ Primary

Addresses

Primary practice location

1400 N San Antonio Ave
Douglas, AZ 85607-2434

Mailing address

1400 N San Antonio Ave
Douglas, AZ 85607-2434
Phone (520) 364-7937

Other identifiers 1

IdentifierTypeStateIssuer
707416MedicaidAZ

National Provider Directory

National Provider Directory

Locations

1400 N San Antonio Ave
Douglas, AZ 85607
Phone (520) 364-7937

NPI Registry JSON

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234310400000",
    "number": "1366681520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 N SAN ANTONIO AVE",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856072434",
            "telephone_number": "520-364-7937",
            "fax_number": "520-805-9146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N SAN ANTONIO AVE",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856072434",
            "telephone_number": "520-364-7937",
            "fax_number": "520-805-9146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA SOLANA CARE AND REHAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-11",
        "last_updated": "2009-02-11",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "SYSTEMS ADMINISTRATOR",
        "authorized_official_telephone_number": "801-296-5106",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AZ",
            "license": "NCI-388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "707416",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; 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.