Inn at the Amethyst

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

INN AT THE AMETHYST

Practice address

18172 N 91St Ave
Peoria, AZ 85382-3001

Phone

(623) 974-5847

NPI assigned

Mar 25, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Jon Harder

Title

Manager

Phone

(916) 485-8600

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487771267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 FAIRVIEW INDUSTRIAL DR SE STE 270",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024975",
            "telephone_number": "916-485-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18172 N 91ST AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853823001",
            "telephone_number": "623-974-5847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INN AT THE AMETHYST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARDER",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "916-485-8600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6408545",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.