Bannon Springs Ranch Christain Health Care

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ALC-5813 Issued in AZ

Legal business name

BANNON SPRINGS RANCH CHRISTAIN HEALTH CARE

Practice address

Lot 20 County Rd #3398
Vernon, AZ 85940

Phone

(928) 532-0206

Fax

(877) 311-9315

NPI assigned

Feb 28, 2007

Organization subpart

No

Name

Ms. Audrey Wilson

Title

Director

Phone

(928) 532-0206

Tax ID family

Bannon Springs Ranch Christain Health Care3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Bannon Springs Ranch Christain Health Care

  • Assisted Living Facility
  • Vernon, AZ
  • NPI 1194852624
  NPD tax ID
• Bannon Springs Ranch Christain Health Care

  • Assisted Living Facility
  • Vernon, AZ
  • NPI 1720116577
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487781902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 485",
            "city": "VERNON",
            "state": "AZ",
            "postal_code": "859400485",
            "telephone_number": "928-532-0206",
            "fax_number": "877-311-9315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LOT 20 COUNTY RD #3398",
            "city": "VERNON",
            "state": "AZ",
            "postal_code": "85940",
            "telephone_number": "928-532-0206",
            "fax_number": "877-311-9315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNON SPRINGS RANCH CHRISTAIN HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "928-532-0206",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "ALC-5813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "643529",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "614538",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045320",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angel Wings Assisted Living, Inc
• Bannon Springs Ranch Christain Health Care
• Bannon Springs Ranch Christain Health Care
• Beacon Charities
• Pierce Herbert Goodman, D.D.S.
• Julie Ann Nicholson, LPC
• Scott M. Jensen M.D. Inc.

• All providers in Vernon, AZ
• 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.