NPIMap

Organization Active NPI

Az Advanced Care LLC

Doing business as West Lane Home

  • Adult Care Home Facility
  • Phoenix, AZ
National Provider Identifier
1447645833
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
AL9510H Issued in AZ
Legal business name
AZ ADVANCED CARE LLC
Doing business as
West Lane Home
Practice address
3137 W Lane Ave
Phoenix, AZ 85051-6522
Phone
(602) 332-0780
Fax
(877) 517-2224
NPI assigned
Apr 2, 2015
Last updated
Apr 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

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

Authorized official

Name
Rebecca T. SiddiquiNPI 1346645702
Title
Administrator
Phone
(602) 332-0780

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X AL9510H AZ Primary

Addresses

Primary practice location

3137 W Lane Ave
Phoenix, AZ 85051-6522

Mailing address

3137 W Lane Ave
Phoenix, AZ 85051-6522
Phone (602) 332-0780

Other names 1

  • West Lane Home Doing business as

National Provider Directory

National Provider Directory
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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Lane Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 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.