Under Angel Wings Care Home L.L.C

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

UNDER ANGEL WINGS CARE HOME L.L.C

Practice address

18468 W Monterosa St
Goodyear, AZ 85395-6457

Phone

(602) 568-3714

NPI assigned

Sep 15, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Michael Joseph Castillo, B.S.

Title

Ceo

Phone

(602) 568-3714

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1536969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536969600000",
    "number": "1497239446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18468 W MONTEROSA ST",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853956457",
            "telephone_number": "602-568-3714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18468 W MONTEROSA ST",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853956457",
            "telephone_number": "602-568-3714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNDER ANGEL WINGS CARE HOME L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-15",
        "last_updated": "2018-09-15",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-568-3714",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2018; 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.