NPIMap

Organization Active NPI

Pastalino Manor LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Chandler, AZ
National Provider Identifier
1386940401
Registry record updated Feb 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
BH-3710 Issued in AZ
Legal business name
PASTALINO MANOR LLC
Practice address
1383 W Kesler LN
Chandler, AZ 85224-7289
Phone
(480) 634-5485
Fax
(480) 634-5485
NPI assigned
Feb 7, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2011

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

Authorized official

Name
Mr. Paul Kivila
Title
Program Director
Phone
(951) 236-4717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X BH-3710 AZ Primary

Addresses

Primary practice location

1383 W Kesler LN
Chandler, AZ 85224-7289

Mailing address

1383 W Kesler LN
Chandler, AZ 85224-7289
Phone (480) 634-5485

Other identifiers 1

IdentifierTypeStateIssuer
BH-3710OtherAZAZ DEPT. OF HEALTH OBHL LICENSE NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Pastalino Manor LLC 59 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1297036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297036800000",
    "number": "1386940401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1383 W KESLER LN",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852247289",
            "telephone_number": "480-634-5485",
            "fax_number": "480-634-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1383 W KESLER LN",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852247289",
            "telephone_number": "480-634-5485",
            "fax_number": "480-634-5485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASTALINO MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-07",
        "last_updated": "2011-02-07",
        "status": "A",
        "authorized_official_last_name": "KIVILA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "951-236-4717",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "AZ",
            "license": "BH-3710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ DEPT. OF HEALTH OBHL LICENSE NUMBER",
            "identifier": "BH-3710",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; 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.