Organization Active NPI

Desert View Assisted Living

  • Adult Care Home Facility
  • Phoenix, AZ
National Provider Identifier
1386147262
Registry record updated Mar 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
AL9754H Issued in AZ
Legal business name
DESERT VIEW ASSISTED LIVING
Practice address
9401 N 36 Ave
Phoenix, AZ 85051-3305
Phone
(602) 841-7669
Fax
(602) 714-6441
NPI assigned
Mar 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2018

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

Authorized official

Name
Puica Pamela Bebec
Title
Administrator
Phone
(602) 841-7669

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X AL9754H AZ Primary

Addresses

Primary practice location

9401 N 36 Ave
Phoenix, AZ 85051-3305

Mailing address

9407 N 36TH Ave
Phoenix, AZ 85051-3305
Phone (602) 841-7669

Other identifiers 1

IdentifierTypeStateIssuer
878754MedicaidAZ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521158400000",
    "number": "1386147262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9407 N 36TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850513305",
            "telephone_number": "602-841-7669",
            "fax_number": "602-714-6441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 N 36 AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850513305",
            "telephone_number": "602-841-7669",
            "fax_number": "602-714-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT VIEW ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-16",
        "last_updated": "2018-03-16",
        "status": "A",
        "authorized_official_last_name": "BEBEC",
        "authorized_official_first_name": "PUICA",
        "authorized_official_middle_name": "PAMELA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-841-7669"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "AZ",
            "license": "AL9754H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "878754",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Mar 16, 2018; 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.