Az Advanced Care LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

AL9510H Issued in AZ

Legal business name

AZ ADVANCED CARE LLC

Practice address

3137 W Lane Ave
Phoenix, AZ 85051-6522

Phone

(602) 332-0780

Fax

(877) 517-2224

NPI assigned

Apr 2, 2015

Organization subpart

No

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

Authorized official

Name

Rebecca T. Siddiqui

Title

Administrator

Phone

(602) 332-0780

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• West Lane Home Doing business as

Tax ID family

Az Advanced Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Golden Life Assisted Living Home-1

  • Adult Care Home Facility
  • Phoenix, AZ
  • NPI 1558753533
  NPD tax ID

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427932800000",
    "number": "1447645833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3137 W LANE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850516522",
            "telephone_number": "602-332-0780",
            "fax_number": "877-517-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3137 W LANE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850516522",
            "telephone_number": "602-332-0780",
            "fax_number": "877-517-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ ADVANCED CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-02",
        "last_updated": "2015-04-02",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-332-0780"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "AZ",
            "license": "AL9510H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "963085",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Lane Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Navid Anjum Ayub, M.D
• Samina Ayub, M.D.
• Shehzad Hassan Ayub, D.O.
• Nadine Ayudiani
• Az Accident Chiropractic
• Az Anesthesia Group LLC
• Az Anesthesia Services LLC
• Az Anesthesiology Consultants LLC
• Az Behavioral Health Services LLC
• Az Best Hospice Care Inc

• Adult Care Home Facility in Phoenix, AZ
• Providers in Phoenix, 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 Apr 2, 2015; 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.